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General NPI Number Information
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NPI Number | 1982566832
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Entity Type | Individual
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Provider Name | BRISTOL GARRETT COTA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 150 MARINER HEALTH WAY
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3215
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Country | US
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Telephone | 864-787-7990
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Fax |
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Provider Business Mailing Address
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Address Line | 150 MARINER HEALTH WAY
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3215
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Country | US
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Telephone | 864-787-7990
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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 | OTA13851
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License Number State | FL
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