Individual
MICHEL BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
12725 SW 64TH TER, MIAMI, FL 33183-1345
(786) 413-5965
Mailing address
12725 SW 64TH TER, MIAMI, FL 33183-1345
(786) 413-5965
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13125
FL
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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