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Individual

MS. ANGELINA AVANESOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
3301 COLLEGE AVE RM 1441, DAVIE, FL 33314-7721
(954) 262-4100
Mailing address
PO BOX 290370, DAVIE, FL 33329-0370
(954) 262-4100

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
225X00000X
Occupational Therapist
Primary
OT26659
FL

Other

Enumeration date
08/29/2017
Last updated
05/05/2026
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