Individual
GRETER VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12155 SW 123RD PASS, MIAMI, FL 33186-5438
(305) 253-2616
Mailing address
12155 SW 123RD PASS, MIAMI, FL 33186-5438
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11675
FL
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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