Individual
LESLEY PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 PROVINCETOWN PL, ORLANDO, FL 32827-4918
(407) 536-3173
Mailing address
3125 PROVINCETOWN PL, ORLANDO, FL 32827-4918
(407) 536-3173
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15878
FL
Other
Enumeration date
09/05/2017
Last updated
07/21/2022
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