Individual
MARY MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7365 MERCHANT CT, LAKEWOOD RANCH, FL 34240-8447
(941) 702-2035
Mailing address
133 W PERRY LN, ENGLEWOOD, FL 34223-2943
(941) 499-6660
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA19185
FL
Other
Enumeration date
06/07/2019
Last updated
10/17/2023
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