Individual
LISSANDRA ORTEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16445 NW 22ND AVE, OPA LOCKA, FL 33054-6649
(786) 277-9180
Mailing address
16445 NW 22ND AVE, OPA LOCKA, FL 33054-6649
(786) 277-9180
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13000
FL
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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