Healthcare Provider Details

I. General information

NPI: 1083182075
Provider Name (Legal Business Name): NATALIE CHRISTINE ZILLI COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 N US HIGHWAY 1
MELBOURNE FL
32935-4822
US

IV. Provider business mailing address

976 SHAW CIR
MELBOURNE FL
32940-6963
US

V. Phone/Fax

Practice location:
  • Phone: 719-238-7887
  • Fax:
Mailing address:
  • Phone: 719-238-7887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number16591
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: