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NPI Code Detail

MEDICARE: MS. WENDY ANN INGRAM COTA

MEDICARE: MS. WENDY ANN INGRAM 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
1224Z00000XOccupational Therapy Assistant13989FL

General Provider Information

NPI Number : 1700442373
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. WENDY ANN INGRAM COTA
Provider Business Mailing Address
First Line : 3128 SIR HAMILTON CIR
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-4962
Country : US
Telephone Number : 407-233-5244
Fax Number :
Provider Business Practice Location Address
First Line : 1705 JESS PARRISH CT
Second Line :
City : TITUSVILLE
State : FL
Zip : 32796-2158
Country : US
Telephone Number : 321-269-5720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2019
Last Update Date : 05/19/2019

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