Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT16028 | FL |
NPI | 1255733291 |
---|---|
Provider Name | Gilberto Avila |
First Address | Miami, FL 33265-2322 |
Second Address | Miami, FL 33165-5542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 18/03/2021 |