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General NPI Number Information
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NPI Number | 1386364958
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Entity Type | Individual
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Provider Name | TIFFANY RAE TINO COTA
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Gender | Female
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 1700 N DIXIE HWY STE 116
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City | BOCA RATON
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State | FL
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Zip | 33432-1807
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Country | US
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Telephone | 844-397-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 SW 21ST AVE
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City | BOCA RATON
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State | FL
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Zip | 33486-8523
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Country | US
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Telephone | 518-421-4619
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 359826
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License Number State | FL
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