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General NPI Number Information
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NPI Number | 1508193665
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Entity Type | Individual
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Provider Name | TERRENCE ALPHONSE DUFFEY COTA
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Gender | Male
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 11301 CORPORATE BLVD SUITE 101
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City | ORLANDO
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State | FL
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Zip | 32817-8354
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Country | US
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Telephone | 877-896-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 924 GORHAM CT
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City | MIDLOTHIAN
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State | VA
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Zip | 23114-4648
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Country | US
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Telephone | 804-514-2558
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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 |
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License Number State |
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