Healthcare Provider Details

I. General information

NPI: 1043745870
Provider Name (Legal Business Name): RITA WILLIAMS COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2017
Last Update Date: 04/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SW 33RD AVE
OCALA FL
34474-4466
US

IV. Provider business mailing address

3172 SE 49TH PL
OCALA FL
34480-8407
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-7776
  • Fax:
Mailing address:
  • Phone: 352-216-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA555
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: