Individual
ANNALIESE LUZ ALICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5165 ADANSON ST, ORLANDO, FL 32804-1331
(352) 394-0212
(352) 241-6361
Mailing address
PO BOX 120547, CLERMONT, FL 34712-0547
(352) 394-0212
(352) 241-6361
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19167
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215017512
—
FL
Enumeration date
09/26/2022
Last updated
09/26/2022
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