Provider Demographics
NPI:1770364168
Name:FRANKEL, STACEY ARICA (COTA)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ARICA
Last Name:FRANKEL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17854 LAKE CARLTON DR APT A
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-6325
Mailing Address - Country:US
Mailing Address - Phone:323-252-2000
Mailing Address - Fax:
Practice Address - Street 1:9035 BRYAN DAIRY RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1104
Practice Address - Country:US
Practice Address - Phone:727-395-9619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA19568224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant