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General NPI Number Information
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NPI Number | 1417445404
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Entity Type | Individual
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Provider Name | EDUARDO FERNANDEZ COTA/L
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Gender | Male
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 8415 SW 24TH ST STE 205
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City | MIAMI
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State | FL
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Zip | 33155-2305
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Country | US
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Telephone | 305-262-6868
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Fax | 305-262-6867
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Provider Business Mailing Address
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Address Line | 11066 SW 247TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-4693
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Country | US
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Telephone | 305-321-8650
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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 | OTA16519
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License Number State | FL
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