MEDICARE: SARAH LYNN PORCHER 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	10200	FL
2	376K00000X	Nurse's Aide	43308	FL

General Provider Information

NPI Number	:	1588877575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LYNN PORCHER COTA

Provider Business Mailing Address
First Line	:	756 PARK VALLEY CIR
Second Line	:
City	:	MINNEOLA
State	:	FL
Zip	:	34715-7955
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 SAN MARCO BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8536
Country	:	US
Telephone Number	:	904-398-4133
Fax Number	:

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	09/11/2025

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