Individual
CELIA DEBBIE REVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
12246 MIRAMAR PKWY, MIRAMAR, FL 33025-7016
(954) 517-8931
Mailing address
5300 PASEO BLVD APT 1212, DORAL, FL 33166-5358
(954) 517-8931
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17750
FL
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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