Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 11608 | FL |
NPI | 1003108341 |
---|---|
Provider Name | Zoraida Mendoza |
First Address | Hialeah, FL 33015-3664 |
Second Address | Hialeah, FL 33015-3664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2011 |
Last Update Date | 04/05/2011 |