Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT8514 | FL |
N | 225XH1200X | Occupational Therapist - Hand | OT8514 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT8514 | FL |
NPI | 1023025293 |
---|---|
Provider Name | Mr. Rene Alfredo Mattey JR. |
First Address | Miami, FL 33176-2306 |
Second Address | Miami, FL 33176-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |