MEDICARE: JESSICA LYNN BIRKLEY 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
1	225XG0600X	Gerontology Occupational Therapist

General Provider Information

NPI Number	:	1306796990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYNN BIRKLEY COTA/L

Provider Business Mailing Address
First Line	:	1004 NE 32ND TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-3511
Country	:	US
Telephone Number	:	216-650-7332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 NE 32ND TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-3511
Country	:	US
Telephone Number	:	216-650-7332
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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