Individual
GABRIELLA MARIA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
13134 SW 29TH ST, MIRAMAR, FL 33027-3837
(954) 249-7472
Mailing address
13134 SW 29TH ST, MIRAMAR, FL 33027-3837
(954) 249-7472
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA16755
AMERICAN OCCUPATIONAL THERAPY ASSOCIATION
FL
Enumeration date
09/04/2018
Last updated
09/04/2018
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