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Individual

BRENDA K EWER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
200 FLORIDA AVE, TAVERNIER, FL 33070-2641
(305) 853-0943
Mailing address
200 FLORIDA AVE, TAVERNIER, FL 33070-2641
(305) 853-0943

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT10819
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26-4091162
TAX ID #
FL
Enumeration date
06/30/2006
Last updated
03/27/2012
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