Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA18230 | FL |
NPI | 1013597137 |
---|---|
Provider Name | Junieth Miranda |
First Address | Miami, FL 33182-2007 |
Second Address | Homestead, FL 33033-5541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2021 |
Last Update Date | 12/04/2021 |