MEDICARE: VANESSA ECHEVERRY 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
1	224Z00000X	Occupational Therapy Assistant	OTA12846	FL

General Provider Information

NPI Number	:	1891174678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ECHEVERRY COTA/L

Provider Business Mailing Address
First Line	:	2500 NE 135TH ST
Second Line	:	1003
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3591
Country	:	US
Telephone Number	:	954-226-6939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 NE 135TH ST
Second Line	:	1003
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3591
Country	:	US
Telephone Number	:	954-226-6939
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	05/26/2015

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Directions to “ VANESSA ECHEVERRY COTA/L” Practice Location

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