Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 006704-1 | NY |
Y | 224Z00000X | Occupational Therapy Assistant | OTA17892 | FL |
NPI | 1013160282 |
---|---|
Provider Name | Ms. Donna Vizcarrondo |
First Address | Orlando, FL 32807-4812 |
Second Address | Longwood, FL 32779-4878 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2008 |
Last Update Date | 16/09/2021 |