Healthcare Provider Details

I. General information

NPI: 1558152082
Provider Name (Legal Business Name): EMILY ANN BEHAL COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2639 W SR 434
LONGWOOD FL
32779-4878
US

IV. Provider business mailing address

133 SUMMIT ASH WAY
APOPKA FL
32703-4869
US

V. Phone/Fax

Practice location:
  • Phone: 407-530-5063
  • Fax:
Mailing address:
  • Phone: 407-463-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA20144
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: