Healthcare Provider Details

I. General information

NPI: 1194428961
Provider Name (Legal Business Name): CHERAIL WASHINGTON COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4889 S CONGRESS AVE STE 202
PALM SPRINGS FL
33461-4762
US

IV. Provider business mailing address

4889 S CONGRESS AVE STE 202
PALM SPRINGS FL
33461-4762
US

V. Phone/Fax

Practice location:
  • Phone: 561-318-5571
  • Fax: 561-355-5244
Mailing address:
  • Phone: 561-318-5571
  • Fax: 561-355-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA14775
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: