Healthcare Provider Details

I. General information

NPI: 1699689323
Provider Name (Legal Business Name): MEREDY RODRIGUEZ COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17001 HOLLAND RD
BROOKPARK OH
44142-3523
US

IV. Provider business mailing address

27045 KENNEDY RIDGE EXT
NORTH OLMSTED OH
44070-4366
US

V. Phone/Fax

Practice location:
  • Phone: 216-898-8307
  • Fax: 216-898-8307
Mailing address:
  • Phone: 330-715-7090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA007048
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: