Organization
COTA MEDICAL MANAGEMENT
Active
Other names
CLINICA DE LA MAMA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FELIPE COTA (CFO)
(678) 584-5865
Entity
Organization
Contact information
Practice address
3750 VENTURE DR, SUITE 140, DULUTH, GA 30096-1808
(678) 584-5865
Mailing address
3750 VENTURE DR, SUITE 140, DULUTH, GA 30096-1808
(678) 584-5865
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2015007976
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10533405993
—
GA
05
—
10937577239
—
GA
Enumeration date
11/09/2015
Last updated
11/09/2015
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