Individual
MILES C. DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1855 SANFORD CIR., SARASOTA, FL 34234
(321) 271-1744
Mailing address
357 CHEVELLE DR., WEST MELBORNE, FL 32904
(321) 271-1744
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10288
FL
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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