Provider Demographics
NPI:1336879113
Name:COTES, ANA (APRN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:COTES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 SW 148TH AVE APT 1611
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3093
Mailing Address - Country:US
Mailing Address - Phone:863-253-2728
Mailing Address - Fax:
Practice Address - Street 1:775 SW 148TH AVE APT 1611
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-3093
Practice Address - Country:US
Practice Address - Phone:863-253-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020246363LP2300X
FL9484859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care