Individual
ALIS LEYDIS CONDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8121 NW 197TH ST, HIALEAH, FL 33015-6344
(786) 608-2619
Mailing address
8121 NW 197TH ST, HIALEAH, FL 33015-6344
(786) 608-2619
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16811
FL
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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