Individual
LORETA MOGOLLON OLIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
13590 SW 134TH AVE, MIAMI, FL 33186-4561
(786) 732-6646
(786) 842-3218
Mailing address
13590 SW 134TH AVE STE 107, MIAMI, FL 33186-4575
(786) 732-6646
(786) 842-3218
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11333
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA 11333
DOH
FL
Enumeration date
12/27/2016
Last updated
12/27/2016
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