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General NPI Number Information
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NPI Number | 1104094515
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Entity Type | Individual
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Provider Name | ANGELA CLAIRE MARINA COTA/L
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Gender | Female
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 7227 LAND O LAKES BOULEVARD
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City | LAND O LAKES
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State | FL
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Zip | 34639
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Country | US
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Telephone | 727-774-2602
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Fax |
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Provider Business Mailing Address
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Address Line | 8026 BUTTONBALL LANE
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City | PORT RICHEY
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State | FL
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Zip | 34668-7012
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA231
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License Number State | FL
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