Individual
MR. ANTHONY BENCOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
5725 NW 186TH ST, MIAMI GARDENS, FL 33015-6019
(305) 625-9857
Mailing address
10901 SW 106TH AVE, MIAMI, FL 33176-3440
(305) 632-5950
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10450
FL
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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