Provider Demographics
NPI:1023139862
Name:GOPAUL, BARRY KEVIN (COTA)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:KEVIN
Last Name:GOPAUL
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 1:8356 S CORAL CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4147
Mailing Address - Country:US
Mailing Address - Phone:954-895-8790
Mailing Address - Fax:
Practice Address - Street 1:7650 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2967
Practice Address - Country:US
Practice Address - Phone:954-726-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist