MEDICARE: MARISSA COTA MSW

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	1041C0700X	Clinical Social Worker	SW12710	FL

General Provider Information

NPI Number	:	1215244538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA COTA MSW

Provider Business Mailing Address
First Line	:	12430 SW 143RD LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6035
Country	:	US
Telephone Number	:	305-928-9073
Fax Number	:

Provider Business Practice Location Address
First Line	:	4699 N FEDERAL HWY
Second Line	:	SUITE 102F
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6510
Country	:	US
Telephone Number	:	305-928-9073
Fax Number	:

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

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	02/15/2016

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Directions to “ MARISSA COTA MSW” Practice Location

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