MEDICARE: MRS. SUZANNE SCHUH 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	OTA9877	FL

General Provider Information

NPI Number	:	1457803033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUZANNE SCHUH COTA

Provider Business Mailing Address
First Line	:	530 MOBLEY DR
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-8271
Country	:	US
Telephone Number	:	407-484-8202
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 CRANES ROOST BLVD
Second Line	:	SUITE 2090
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3468
Country	:	US
Telephone Number	:	407-388-8866
Fax Number	:	407-494-0644

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

Provider Enumeration Date	:	10/28/2016
Last Update Date	:	10/30/2016

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