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NPI Code Detail

MEDICARE: MIRANDA WAITE COTA

MEDICARE: MIRANDA WAITE COTA
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 AssistantOTA007479OH

General Provider Information

NPI Number : 1306303722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA WAITE COTA
Provider Business Mailing Address
First Line : 2771 OAK ST
Second Line :
City : WILLOUGHBY HILLS
State : OH
Zip : 44094-9117
Country : US
Telephone Number : 440-488-8570
Fax Number :
Provider Business Practice Location Address
First Line : 402 GOLFVIEW LN
Second Line :
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-4414
Country : US
Telephone Number : 440-443-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2019
Last Update Date : 02/21/2019

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