Provider Demographics
NPI:1720266919
Name:UNITED HEALTH ADVISORY GROUP
Entity Type:Organization
Organization Name:UNITED HEALTH ADVISORY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:COTTA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-342-7144
Mailing Address - Street 1:15148 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9351
Mailing Address - Country:US
Mailing Address - Phone:352-342-7144
Mailing Address - Fax:
Practice Address - Street 1:15148 WILLOW LN
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-9351
Practice Address - Country:US
Practice Address - Phone:352-342-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-10
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0016097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty