Individual
ERICA YUSUPOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1117 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-4488
(954) 458-5040
Mailing address
2790 NE 201ST TER, AVENTURA, FL 33180-2099
(602) 561-8848
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21290
FL
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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