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Individual

TOVA FUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4140 N MERIDIAN AVE, APT 1, MIAMI BEACH, FL 33140-3321
(347) 525-4839
Mailing address
4140 N MERIDIAN AVE, APT 1, MIAMI BEACH, FL 33140-3321

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT13579
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000913500
FL
Enumeration date
06/10/2009
Last updated
08/03/2012
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