Individual
NICOLE MAURICIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
20404 NW 44TH PL, MIAMI GARDENS, FL 33055-1223
(786) 493-8160
Mailing address
20404 NW 44TH PL, MIAMI GARDENS, FL 33055-1223
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12819
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12819
CMS
FL
05
—
12819
—
FL
Enumeration date
12/10/2014
Last updated
05/27/2015
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