Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 4274 | FL |
NPI | 1851751416 |
---|---|
Provider Name | Mrs. Heather Leigh Cadiz |
First Address | Merritt Island, FL 32953-3240 |
Second Address | Merritt Island, FL 32953-3240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2016 |
Last Update Date | 25/02/2016 |