MEDICARE: AIMEE SARDINAS 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
1	224Z00000X	Occupational Therapy Assistant	OTA16110	FL

General Provider Information

NPI Number	:	1104339977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE SARDINAS COTA

Provider Business Mailing Address
First Line	:	11856 SW 98TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17670 NW 78TH AVE STE 113
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-3665
Country	:	US
Telephone Number	:	305-512-5757
Fax Number	:	305-512-5755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2017
Last Update Date	:	11/14/2017

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