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Individual

BYANCA BOLIVARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1520 NW 140TH MNR, PEMBROKE PINES, FL 33028-3011
(954) 696-8221
Mailing address
575 NW 143RD ST, MIAMI, FL 33168-4113
(786) 468-4011

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16536
FL

Other

Enumeration date
10/02/2023
Last updated
10/02/2023
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