Individual provider Active NPI

Raymond Cruz Molina, COTA/L

  • Occupational Therapy Assistant
  • Winter Haven, FL
National Provider Identifier
1780346916
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA18506 Issued in FL
Practice address
202 Avenue O NE
Winter Haven, FL 33881-2499
Phone
(863) 293-3103
Fax
(863) 294-5767
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA18506 FL Primary

Addresses

Primary practice location

202 Avenue O NE
Winter Haven, FL 33881-2499

Mailing address

303 Flint St
Haines City, FL 33844-8220
Phone (352) 978-5866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA18506FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1780346916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 FLINT ST",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338448220",
            "telephone_number": "352-978-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 AVENUE O NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812499",
            "telephone_number": "863-293-3103",
            "fax_number": "863-294-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ MOLINA",
        "first_name": "RAYMOND",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA18506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.