Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA14910 | FL |
NPI | 1013484195 |
---|---|
Provider Name | Patrycja Ataides |
First Address | Homestead, FL 33032-8170 |
Second Address | Homestead, FL 33033-5541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2018 |
Last Update Date | 27/10/2018 |