Healthcare Provider Details

I. General information

NPI: 1407160468
Provider Name (Legal Business Name): STEPHANIE CIFUENTES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5979 NW 151ST ST STE 103
MIAMI LAKES FL
33014-2400
US

IV. Provider business mailing address

5979 NW 151ST ST STE 103
MIAMI LAKES FL
33014-2400
US

V. Phone/Fax

Practice location:
  • Phone: 786-664-8757
  • Fax: 305-827-8510
Mailing address:
  • Phone: 786-664-8757
  • Fax: 305-827-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT13888
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: