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General NPI Number Information
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NPI Number | 1497046593
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Entity Type | Individual
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Provider Name | CHARMAINE ROSE LEWIS COTA
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Gender | Female
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 5830 CORAL RIDGE DR SUITE #120
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3392
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Country | US
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Telephone | 954-752-6065
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Fax | 954-752-5746
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Provider Business Mailing Address
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Address Line | 11260 NW 41ST CT
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7764
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Country | US
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Telephone | 954-822-9560
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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 | 11022
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 210594
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License Number State | TX
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