Individual
LUPE COLLADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
11529 NW 10TH ST, PEMBROKE PINES, FL 33026-4330
(954) 649-3675
Mailing address
11529 NW 10TH ST, PEMBROKE PINES, FL 33026-4330
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11351
FL
Other
Enumeration date
03/31/2019
Last updated
03/31/2019
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