Individual
MR. JOSE LUIS MAQUERA FRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
17551 DALE MABRY HWY N, SUITE #5, LUTZ, FL 33548-4521
(813) 766-3157
(813) 920-9823
Mailing address
13949 JACOBSON DR, ODESSA, FL 33556-1763
(813) 766-3157
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3218
FL
Other
Enumeration date
10/03/2006
Last updated
10/30/2007
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