Individual
MALLORY FIORUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
550 NATIONAL HEALTH CARE DR, DAYTONA BEACH, FL 32114-1494
(386) 257-6362
Mailing address
5400 CORACI BLVD APT 5201, PORT ORANGE, FL 32128-7575
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17762
FL
Other
Enumeration date
10/31/2020
Last updated
10/31/2020
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