Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1528644507 |
---|---|
Provider Name | Peter Pelobello |
First Address | Miami, FL 33161-2898 |
Second Address | North Miami, FL 33161-2898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2021 |
Last Update Date | 22/03/2021 |