MEDICARE: JYOT SINGH 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	15333	FL

General Provider Information

NPI Number	:	1265946503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JYOT SINGH COTA/L

Provider Business Mailing Address
First Line	:	5394 OSPREY ST
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-2620
Country	:	US
Telephone Number	:	954-793-6814
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 US HIGHWAY 1 STE 210
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3547
Country	:	US
Telephone Number	:	561-776-8612
Fax Number	:

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

Provider Enumeration Date	:	11/23/2017
Last Update Date	:	11/23/2017

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