Individual
ANDREA JUANA FOURCADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9697 SW 147TH CT, MIAMI, FL 33196-1677
(786) 985-0667
Mailing address
9697 SW 147TH CT, MIAMI, FL 33196-1677
(786) 985-0667
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-55270
FL
224Z00000X
Occupational Therapy Assistant
COTA13373
FL
Other
Enumeration date
09/03/2014
Last updated
04/26/2022
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