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General NPI Number Information
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NPI Number | 1104098524
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Entity Type | Individual
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Provider Name | ASHLEY MARIE VIA COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 250 S CHICKASAW TRL
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City | ORLANDO
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State | FL
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Zip | 32825-3503
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Country | US
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Telephone | 407-380-3466
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 DANIELLE DR
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City | OVIEDO
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State | FL
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Zip | 32765-7588
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Country | US
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Telephone | 386-956-8654
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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 | OTA 10553
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License Number State | FL
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