Individual
DANA RAE DEREQUITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7457 ALOMA AVE STE 201, WINTER PARK, FL 32792-9172
(407) 815-4954
Mailing address
7457 ALOMA AVE STE 201, WINTER PARK, FL 32792-9172
(407) 815-4954
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
24123
FL
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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