Provider Demographics
NPI:1649708082
Name:PAPAYOUTE, ROMANCHES (COTA)
Entity type:Individual
Prefix:
First Name:ROMANCHES
Middle Name:
Last Name:PAPAYOUTE
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 18TH ST SE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-9468
Mailing Address - Country:US
Mailing Address - Phone:813-446-1557
Mailing Address - Fax:
Practice Address - Street 1:7801 AIRPORT PULLING RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-1717
Practice Address - Country:US
Practice Address - Phone:239-567-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12388224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant