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General NPI Number Information
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NPI Number | 1043522691
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Entity Type | Individual
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Provider Name | GLORIA MARCELA GRAJALES OTR
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Gender | Female
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 8955 SW 87TH CT SUITE 210
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City | MIAMI
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State | FL
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Zip | 33176-2230
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Country | US
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Telephone | 786-363-3900
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Fax | 305-630-9654
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Provider Business Mailing Address
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Address Line | 4104 NE 22ND CT
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City | HOMESTEAD
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State | FL
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Zip | 33033-5134
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Country | US
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Telephone | 305-333-0284
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Fax | 800-281-0545
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT13889
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License Number State | FL
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