Randy Roy Smith, COTA/L
Occupational Therapy Assistant in Lauderdale Lakes, FL. Individual provider (NPI-1).
NPI number1164079331
StatusActive
Last updated in NPPESAug 22, 2019
Details
- NPI
- 1164079331
- Entity type
- Individual (NPI-1)
- Name
- Mr. Randy Roy Smith
- Credential
- COTA/L
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 22, 2019
- Last updated
- Aug 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | A02807 | MD | Yes |
Practice location
3100 Nw 39th StLauderdale Lakes, FL 33309-4918
Phone 954-513-8184
Mailing address
3100 Nw 39th StLauderdale Lakes, FL 33309-4918
Phone 954-513-8184
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