Provider Demographics
NPI:1871911982
Name:MENESES, VICTORIA EUGENIA (COTA)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:EUGENIA
Last Name:MENESES
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 1:134 ALDEA DR
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-6949
Mailing Address - Country:US
Mailing Address - Phone:772-480-6810
Mailing Address - Fax:
Practice Address - Street 1:134 ALDEA DR
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-6949
Practice Address - Country:US
Practice Address - Phone:772-480-6810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA13531224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant