Individual
ALFA OSIRIS ILLESCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
12400 SW 72ND ST, MIAMI, FL 33183-2514
(305) 760-6570
(305) 412-6464
Mailing address
12400 SW 72ND ST, MIAMI, FL 33183-2514
(305) 760-6570
(305) 412-6464
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13651
FL
Other
Enumeration date
07/03/2009
Last updated
07/28/2010
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