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NPI Code Detail

MEDICARE: MIRINISA FORTUNATO COTA

MEDICARE:   MIRINISA  FORTUNATO  COTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant5836AZ

General Provider Information

NPI Number : 1073927216
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRINISA FORTUNATO COTA
Provider Business Mailing Address
First Line : 3813 W IVANHOE ST
Second Line :
City : CHANDLER
State : AZ
Zip : 85226-2212
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8850 E PIMA CENTER PKWY
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4619
Country : US
Telephone Number : 480-800-3900
Fax Number : 717-412-9480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2014
Last Update Date : 03/18/2021

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Directions to “ MIRINISA FORTUNATO COTA” Practice Location

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