Healthcare Provider Details

I. General information

NPI: 1528542339
Provider Name (Legal Business Name): HANNAH NICOLE BEDROSIAN COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH NICOLE SHIRELING COTA

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11417 BRAHMAN RD
LITHIA FL
33547-2007
US

IV. Provider business mailing address

11417 BRAHMAN RD
LITHIA FL
33547-2007
US

V. Phone/Fax

Practice location:
  • Phone: 813-579-7548
  • Fax:
Mailing address:
  • Phone: 813-579-7548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA16313
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: