Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA538 | FL |
NPI | 1023277449 |
---|---|
Provider Name | Mrs. Sandra Lee Pezzino |
First Address | Jupiter, FL 33478-6334 |
Second Address | Jupiter, FL 33478-6334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 02/06/2008 |