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General NPI Number Information
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NPI Number | 1629584248
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Entity Type | Individual
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Provider Name | LAURIE ANN COX COTA/L
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 145 MIDDLE ST STE 1101
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City | LAKE MARY
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State | FL
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Zip | 32746-3594
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Country | US
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Telephone | 407-985-0658
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Fax | 407-985-0658
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Provider Business Mailing Address
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Address Line | 1645 BRADY DR
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City | DELTONA
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State | FL
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Zip | 32725-6001
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Country | US
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Telephone | 256-872-0167
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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 | 15390
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License Number State | FL
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