Basic Information
| Provider Information | |||||||||
| NPI: | 1437571361 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | CASSANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 198 VELVETEEN PL | ||||||||
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| City: | CHULUOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327666022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075798619 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12702 SCIENCE DR | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328263016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078523300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2014 | ||||||||
| LastUpdateDate: | 03/06/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | OT16156 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.