Provider Demographics
NPI:1538854609
Name:COBOS, KAYLA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:COBOS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 E LAKE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2404
Mailing Address - Country:US
Mailing Address - Phone:727-786-1996
Mailing Address - Fax:
Practice Address - Street 1:3488 E LAKE RD STE 302
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2404
Practice Address - Country:US
Practice Address - Phone:727-786-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT23525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist