Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT8119 | FL |
NPI | 1053311498 |
---|---|
Provider Name | Ms. Camille Arevalo |
First Address | Hollywood, FL 33020-2645 |
Second Address | Hollywood, FL 33020-2645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 08/07/2007 |