Individual
MRS. CHARISMA LYN QUIAMBAO FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
170 N CENTER ST, ORMOND BEACH, FL 32174-5186
(386) 672-7113
Mailing address
875 WILMETTE AVE APT 715, ORMOND BEACH, FL 32174-9517
(407) 683-2020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR12516
OCCUPATIONAL THERAPIST
FL
Enumeration date
03/16/2007
Last updated
07/08/2007
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