MEDICARE: ELIZA HERNANDEZ COTA/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1184505448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZA HERNANDEZ COTA/L

Provider Business Mailing Address
First Line	:	901 S SOONER RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-2425
Country	:	US
Telephone Number	:	405-610-1909
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 S SOONER RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-2425
Country	:	US
Telephone Number	:	405-610-1909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/11/2025

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