Healthcare Provider Details

I. General information

NPI: 1255505988
Provider Name (Legal Business Name): TONI SEXTON COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 37TH AVE N SUITE A
ST PETERSBURG FL
33713-1509
US

IV. Provider business mailing address

3101 37TH AVE N SUITE A
ST PETERSBURG FL
33713-1509
US

V. Phone/Fax

Practice location:
  • Phone: 727-328-0599
  • Fax: 727-328-2071
Mailing address:
  • Phone: 727-328-0599
  • Fax: 727-328-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA4643
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: