MEDICARE: MARLENE STINE 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
1	224Z00000X	Occupational Therapy Assistant	13584	FL

General Provider Information

NPI Number	:	1356759252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE STINE COTA

Provider Business Mailing Address
First Line	:	2319 DOVER AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-4218
Country	:	US
Telephone Number	:	239-931-0550
Fax Number	:

Provider Business Practice Location Address
First Line	:	2319 DOVER AVE
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33907-4218
Country	:	US
Telephone Number	:	239-931-0550
Fax Number	:

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

Provider Enumeration Date	:	07/24/2014
Last Update Date	:	07/24/2014

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Directions to “ MARLENE STINE COTA” Practice Location

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