Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA15630 | FL |
NPI | 1013433952 |
---|---|
Provider Name | Natalie Lopez |
First Address | Miami, FL 33126-2712 |
Second Address | Miami, FL 33126-2712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2017 |
Last Update Date | 17/03/2018 |