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NPI Code Detail

MEDICARE: SHEENA COOPER COTA

MEDICARE: SHEENA COOPER 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 Assistant

General Provider Information

NPI Number : 1790372654
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEENA COOPER COTA
Provider Business Mailing Address
First Line : 4426 LENOX BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32811-4541
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4875 CASON COVE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32811-6302
Country : US
Telephone Number : 407-420-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2020
Last Update Date : 12/28/2020

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Directions to “ SHEENA COOPER COTA” Practice Location

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