Individual
DEYRIS CONSUELO CORREA FORTEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10951 SW 72ND TER, MIAMI, FL 33173-2743
(786) 291-2578
Mailing address
10951 SW 72ND TER, MIAMI, FL 33173-2743
(786) 291-2578
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OT19952
FL
Other
Enumeration date
05/06/2019
Last updated
11/12/2024
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