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Individual

MRS. ELYZABETH BOLANOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
985 E 2ND ST, HIALEAH, FL 33010-5157
(786) 704-4583
Mailing address
985 E 2ND ST, HIALEAH, FL 33010-5157
(786) 704-4583

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12632
FL

Other

Enumeration date
04/26/2022
Last updated
04/26/2022
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