MEDICARE: ERIN WHITBRED 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	OTA 14985	FL

General Provider Information

NPI Number	:	1295191492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN WHITBRED COTA

Provider Business Mailing Address
First Line	:	3118 SE 8TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-3513
Country	:	US
Telephone Number	:	239-994-5310
Fax Number	:

Provider Business Practice Location Address
First Line	:	3118 SE 8TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-3513
Country	:	US
Telephone Number	:	239-994-5310
Fax Number	:

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

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	02/15/2016

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