Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT0003911 | FL |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT0003911 | FL |
NPI | 1386600245 |
---|---|
Provider Name | Cristiane Carmo |
First Address | Valrico, FL 33594-4223 |
Second Address | Valrico, FL 33594 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 03/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
885541200 | (05) | FL |
889657700 | (05) | FL |