Healthcare Provider Details

I. General information

NPI: 1952221228
Provider Name (Legal Business Name): MAYRA LISSETH BARRERA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5341 JOG LN
DELRAY BEACH FL
33484-6624
US

IV. Provider business mailing address

5341 JOG LN
DELRAY BEACH FL
33484-6624
US

V. Phone/Fax

Practice location:
  • Phone: 561-789-3488
  • Fax:
Mailing address:
  • Phone: 561-789-3488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT17616
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: