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NPI Code Detail

MEDICARE: DEBBIE MROZ COTA

MEDICARE: DEBBIE MROZ 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 AssistantFL

General Provider Information

NPI Number : 1396934931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBBIE MROZ COTA
Provider Business Mailing Address
First Line : PO BOX 14223
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29587-4223
Country : US
Telephone Number : 843-467-9775
Fax Number :
Provider Business Practice Location Address
First Line : 9393 PARK BLVD
Second Line :
City : SEMINOLE
State : FL
Zip : 33777-4140
Country : US
Telephone Number : 813-920-1989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2007
Last Update Date : 10/19/2007

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