Healthcare Provider Details

I. General information

NPI: 1114985124
Provider Name (Legal Business Name): CHRISTINA ANASTASIA SUAREZ M.O.T., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 06/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 S ORANGE AVE
ORLANDO FL
32806-6125
US

IV. Provider business mailing address

151 W CEDARWOOD CIR
KISSIMMEE FL
34743-9021
US

V. Phone/Fax

Practice location:
  • Phone: 407-852-3300
  • Fax: 407-852-3301
Mailing address:
  • Phone: 321-285-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT10037
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: