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General NPI Number Information
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NPI Number | 1013944305
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Entity Type | Individual
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Provider Name | ADRIANA D TILLEY O.T
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2020 NE 163RD ST 207
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 954-549-3765
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Fax | 305-945-8054
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Provider Business Mailing Address
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Address Line | 2020 NE 163RD ST
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City | N MIAMI BEACH
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State | FL
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Zip | 33162-4927
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Country | US
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Telephone | 954-549-3765
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Fax | 305-945-8054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | 11746
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT11746
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License Number State | FL
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