Individual
CRISTHIAN E MOGOLLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
13590 SW 134TH AVE STE 107, MIAMI, FL 33186-4575
(786) 732-6646
(786) 842-3218
Mailing address
13590 SW 134TH AVE STE 107, MIAMI, FL 33186-4575
(786) 732-6646
(786) 842-3218
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
14121
FL
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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