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General NPI Number Information
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NPI Number | 1518732916
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Entity Type | Individual
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Provider Name | CARLI MASIARCZYK COTA
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Gender | Female
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 2639 W SR 434
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City | LONGWOOD
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State | FL
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Zip | 32779-4878
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Country | US
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Telephone | 620-363-0591
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 E COOPER DR
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City | DELTONA
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State | FL
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Zip | 32725-3639
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Country | US
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Telephone | 620-363-0591
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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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