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Individual

MR. ALBERTO VISILLAS INGALLA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
1335 ARIANA ST, LAKELAND, FL 33803-1879
(863) 413-0802
(863) 413-0812
Mailing address
1335 ARIANA ST, LAKELAND, FL 33803-1879
(863) 413-0802
(863) 413-0812

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225X00000X
OCCUPATIONAL THERAPIST
FL
Enumeration date
05/26/2006
Last updated
07/08/2007
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