Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Kotlicky, ATC/LAT

Individual provider Athletic Trainer · NPI 1720494644

Jacob Kotlicky, ATC/LAT is an Athletic Trainer in Hollywood, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2014
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Practice location Address checks out

3403 Island Rd
Hollywood, FL 33026-1249
Phone: (954) 594-1883
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AL2874 (FL)

Record details

NPI number1720494644
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC/LAT
Sole proprietorYes
NPI enumeratedJuly 11, 2014
Last updated in NPPESJuly 11, 2014

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