MEDICARE: VIVIANA MORENO FERREIRA OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	26560	FL

General Provider Information

NPI Number	:	1578108742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIANA MORENO FERREIRA OTR/L

Provider Business Mailing Address
First Line	:	10940 NW 73RD ST
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33178-3761
Country	:	US
Telephone Number	:	786-301-6352
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 TIMBER TRAIL RD UNIT 103104
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-9415
Country	:	US
Telephone Number	:	912-494-5952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	01/05/2026

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