Healthcare Provider Details

I. General information

NPI: 1841032711
Provider Name (Legal Business Name): CLAUDIA OTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 W 47TH PL STE 449
HIALEAH FL
33012-3455
US

IV. Provider business mailing address

4401 NW 196TH ST
MIAMI GARDENS FL
33055-1816
US

V. Phone/Fax

Practice location:
  • Phone: 305-425-1338
  • Fax:
Mailing address:
  • Phone: 786-764-7785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number24-347786
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: