Healthcare Provider Details

I. General information

NPI: 1699133702
Provider Name (Legal Business Name): LIENA FERNANDEZ M.S., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7684 SW 158 AVE
MIAMI FL
33193
US

IV. Provider business mailing address

7684 SW 158TH AVE
MIAMI FL
33193-2970
US

V. Phone/Fax

Practice location:
  • Phone: 786-348-1694
  • Fax:
Mailing address:
  • Phone: 786-348-1694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT17474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: