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NPI Code Detail

MEDICARE: SARA ELIZABETH BENDER COTA/L

MEDICARE: SARA ELIZABETH BENDER COTA/L
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 Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHER0

General Provider Information

NPI Number : 1295397255
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA ELIZABETH BENDER COTA/L
Provider Business Mailing Address
First Line : 809 APRICOT DR
Second Line :
City : OCOEE
State : FL
Zip : 34761-2413
Country : US
Telephone Number : 434-430-5173
Fax Number :
Provider Business Practice Location Address
First Line : 2202 W OAK AVE
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-7222
Country : US
Telephone Number : 813-754-3761
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2019
Last Update Date : 06/30/2019

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