Healthcare Provider Details

I. General information

NPI: 1538409867
Provider Name (Legal Business Name): DINA MIZRAHI OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2013
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21300 RUTH AND BARON COLEMAN BLVD
BOCA RATON FL
33428-1757
US

IV. Provider business mailing address

21300 RUTH AND BARON COLEMAN BLVD
BOCA RATON FL
33428-1757
US

V. Phone/Fax

Practice location:
  • Phone: 305-528-7139
  • Fax:
Mailing address:
  • Phone: 954-347-0591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: