Individual
MR. JUAN LUIS SALAZAR DE LOS SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
201 PARK PLACE BLVD, KISSIMMEE, FL 34741-2345
(800) 378-7597
Mailing address
536 ROYAL PALM DR, KISSIMMEE, FL 34743
(407) 738-3522
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16336
FL
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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