Healthcare Provider Details
I. General information
NPI: 1043407232
Provider Name (Legal Business Name): MARIA CHRISTINE PEREZ-QUILAB OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/01/2007
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
38250 A AVE
ZEPHYRHILLS FL
33542-5759
US
IV. Provider business mailing address
4139 DYLAN THOMAS DR
WESLEY CHAPEL FL
33543-7148
US
V. Phone/Fax
- Phone: 813-364-5496
- Fax:
- Phone: 863-604-7759
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 013297 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XG0600X |
| Taxonomy | Gerontology Occupational Therapist |
| License Number | OT13140 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: