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General NPI Number Information
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NPI Number | 1083876312
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Entity Type | Individual
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Provider Name | LARAINE CATHERINE ASTARITA COTA
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Gender | Female
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 700 N PALMETTO ST
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City | LEESBURG
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State | FL
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Zip | 34748-4419
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Country | US
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Telephone | 352-323-5609
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Fax |
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Provider Business Mailing Address
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Address Line | 423 HIGHWAY 466 APT 2105
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City | LADY LAKE
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State | FL
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Zip | 32159-3798
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Country | US
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Telephone | 407-687-4174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | OTA9889
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License Number State |
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