Healthcare Provider Details

I. General information

NPI: 1174216311
Provider Name (Legal Business Name): EYMIS VILARRUBIA HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 SW 1ST ST
MIAMI FL
33135-2202
US

IV. Provider business mailing address

2855 W 71ST PL
HIALEAH FL
33018-5339
US

V. Phone/Fax

Practice location:
  • Phone: 305-541-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: