Most Relevant Information
Provider Data
| NPI Number: | 1003641986 |
| Provider Name: | BENJAMIN PATRICK DUCKETT COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA20033 |
Most Important Dates
| Enumeration Date: | 09/03/2024 |
| Last Updated: | 09/03/2024 |
Provider Practice Location
2040 HIGHWAY A1A STE 203
INDIAN HARBOUR BEACH
FL
329373566
Practice Location Phone/Fax
| Phone: | 3217738989 |
| Fax: |
Provider Mailing Location
225 DESOTO PKWY
SATELLITE BEACH
FL
329373330
Provider Mailing Phone/Fax
| Phone: | 3214990559 |
| Fax: |