Individual
DESTENY RUSSO MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
15680 SW 88TH ST STE 201, MIAMI, FL 33196-1160
(305) 570-1666
(305) 203-0546
Mailing address
15680 SW 88TH ST STE 201, MIAMI, FL 33196-1160
(305) 570-1666
(305) 203-0546
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18512
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT18512
LICENSE
FL
Enumeration date
12/11/2018
Last updated
07/07/2021
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