MEDICARE: MIREILLE PIERRE-LOUIS 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	11076	FL
2	224Z00000X	Occupational Therapy Assistant	210862	TX

General Provider Information

NPI Number	:	1992093207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIREILLE PIERRE-LOUIS COTA

Provider Business Mailing Address
First Line	:	14050 NE 3CT APT2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33161
Country	:	US
Telephone Number	:	772-647-1531
Fax Number	:

Provider Business Practice Location Address
First Line	:	11315 CORPORATE BLVD STE 100
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-8340
Country	:	US
Telephone Number	:	800-774-7785
Fax Number	:

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/20/2011

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