Healthcare Provider Details

I. General information

NPI: 1265749261
Provider Name (Legal Business Name): INGRIS TREMINIO MS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 SHERIDAN ST SUITE 209
HOLLYWOOD FL
33026-1505
US

IV. Provider business mailing address

3251 W 70TH ST
HIALEAH FL
33018-7102
US

V. Phone/Fax

Practice location:
  • Phone: 954-431-5437
  • Fax: 954-432-0202
Mailing address:
  • Phone: 786-315-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number14310
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: