Individual
EUGENE QUIAMBAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
9436 AZALEA RIDGE WAY, GOTHA, FL 34734-5064
(407) 523-6987
Mailing address
9436 AZALEA RIDGE WAY, GOTHA, FL 34734-5064
(407) 523-6987
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0006931
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889667400
—
FL
Enumeration date
08/22/2006
Last updated
07/27/2011
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