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Individual

ANTHONY W FAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
815 NW 57TH AVE, SUITE 125, MIAMI, FL 33126-2018
(305) 267-4414
(305) 267-4846
Mailing address
25054 SW 123RD PL, HOMESTEAD, FL 33032-5946
(305) 710-0686

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 9844
FL

Other

Enumeration date
07/08/2013
Last updated
07/08/2013
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