Provider Demographics
NPI:1235951708
Name:DAVILA, ZULEIKA MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:ZULEIKA
Middle Name:MARIE
Last Name:DAVILA
Suffix:
Gender:F
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 1:10446 COLLINS FIELD CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-1694
Mailing Address - Country:US
Mailing Address - Phone:845-391-7862
Mailing Address - Fax:
Practice Address - Street 1:6535 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2250
Practice Address - Country:US
Practice Address - Phone:904-731-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA20078224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant