Individual
DR. KRISTIAN CARLOS LLACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTD,OTR/L, ATP,CSRS
Contact information
Practice address
1239 NW 166TH AVE, PEMBROKE PINES, FL 33028-1345
(305) 431-0887
Mailing address
1239 NW 166TH AVE, PEMBROKE PINES, FL 33028-1345
(305) 431-0887
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
OT16273
FL
225XE0001X
Environmental Modification Occupational Therapist
OT16273
FL
225XE1200X
Ergonomics Occupational Therapist
OT16273
FL
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT16273
FL
225XP0019X
Physical Rehabilitation Occupational Therapist
OT16273
FL
Other
Enumeration date
01/17/2021
Last updated
01/17/2021
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