Kimberly Detrio, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA10512 Issued in FL

Practice address

125 S Swoope Ave Ste 210
Maitland, FL 32751-5784

Phone

(321) 972-4122

Fax

(407) 542-2168

NPI assigned

Mar 26, 2020

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gabriel Therapy Group

  • Clinic/Center
  • Maitland, FL
  • NPI 1841951696
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1770110835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S SWOOPE AVE STE 210",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515784",
            "telephone_number": "321-972-4122",
            "fax_number": "407-542-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S SWOOPE AVE STE 210",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515784",
            "telephone_number": "321-972-4122",
            "fax_number": "407-542-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRIO",
        "first_name": "KIMBERLY",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA10512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Depina
• Linda Lyndsi Deprado, MHC
• Martin A Derita, L.C.S.W., B.C.D.
• Derrow Dermatology Associates LLC
• Martin H. Derrow, M.D.
• Avni Patel Dhaliwal, D.D.S.
• Gurpawan Dhaliwal, MD
• Veronica M Diaz-Diaz, PHD
• Christopher Didonna
• Mary A Dieckman, RN

• Occupational Therapy Assistant in Maitland, FL
• Providers in Maitland, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.