Healthcare Provider Details

I. General information

NPI: 1538625959
Provider Name (Legal Business Name): VERONICA LACERIA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 NE 207TH ST STE B17
MIAMI FL
33180-3705
US

IV. Provider business mailing address

10737 S PRESERVE WAY APT 202
MIRAMAR FL
33025-6557
US

V. Phone/Fax

Practice location:
  • Phone: 305-306-8376
  • Fax:
Mailing address:
  • Phone: 954-806-7140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number19734
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: