Individual
CHARLENE ANTONACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
12107 PARK DR, HOLLYWOOD, FL 33026-1017
(954) 450-2799
Mailing address
12107 PARK DR, HOLLYWOOD, FL 33026-1017
(954) 450-2799
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT15530
FL
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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