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NPI Code Detail

MEDICARE: JOSE ALEXI GRANADOS MOLINA COTA/L

MEDICARE: JOSE ALEXI GRANADOS MOLINA 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
1224Z00000XOccupational Therapy Assistant0131-002464VA

General Provider Information

NPI Number : 1275118853
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE ALEXI GRANADOS MOLINA COTA/L
Provider Business Mailing Address
First Line : 2451 MIDTOWN AVE APT 1517
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22303-1440
Country : US
Telephone Number : 719-557-9453
Fax Number :
Provider Business Practice Location Address
First Line : 7116 FORT HUNT RD
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22307-1900
Country : US
Telephone Number : 703-768-0234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2021
Last Update Date : 03/16/2021

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