Provider Demographics
NPI:1861857120
Name:CASACELI, ADAM (COTA/L)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CASACELI
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12837 MADISON POINTE CIR
Mailing Address - Street 2:UNIT 8201
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6871
Mailing Address - Country:US
Mailing Address - Phone:732-616-2719
Mailing Address - Fax:
Practice Address - Street 1:12837 MADISON POINTE CIR
Practice Address - Street 2:UNIT 8201
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6871
Practice Address - Country:US
Practice Address - Phone:732-616-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14913224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant