Individual
SUMMARA TIBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3210 NW 84TH AVE APT 104, SUNRISE, FL 33351-8913
(954) 839-7422
Mailing address
3210 NW 84TH AVE APT 104, SUNRISE, FL 33351-8913
(954) 839-7422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA14998
FL
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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