Individual
KARLA CARIDAD FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
525 NW 27TH AVE, MIAMI, FL 33125-3043
(305) 200-5073
Mailing address
11930 SW 93RD TER, MIAMI, FL 33186-2059
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17314
FL
224Z00000X
Occupational Therapy Assistant
Primary
OTA17314
FL
252Y00000X
Early Intervention Provider Agency
OTA17314
FL
Other
Enumeration date
07/29/2019
Last updated
03/17/2026
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