Healthcare Provider Details

I. General information

NPI: 1790998367
Provider Name (Legal Business Name): VALERIA M VELA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12608 SW 88TH ST
MIAMI FL
33186-1867
US

IV. Provider business mailing address

9531 SW 151ST AVE
MIAMI FL
33196-1248
US

V. Phone/Fax

Practice location:
  • Phone: 305-412-4177
  • Fax: 305-412-6301
Mailing address:
  • Phone: 786-439-6343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT 12487
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: