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NPI Code Detail

MEDICARE: TINA MARIE WEAVER COTA/L

MEDICARE: TINA MARIE WEAVER 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 Assistant16136FL

General Provider Information

NPI Number : 1346700770
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MARIE WEAVER COTA/L
Provider Business Mailing Address
First Line : 904 WABASH RD
Second Line :
City : VENICE
State : FL
Zip : 34293-6460
Country : US
Telephone Number : 941-650-6036
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S EAST AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2324
Country : US
Telephone Number : 941-365-2422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2019
Last Update Date : 03/21/2019

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Directions to “ TINA MARIE WEAVER COTA/L” Practice Location

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