Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA14052 | FL |
NPI | 1003303041 |
---|---|
Provider Name | Melinda Guerra |
First Address | Miami, FL 33174-1891 |
Second Address | Doral, FL 33166-6671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2018 |
Last Update Date | 16/04/2018 |