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General NPI Number Information
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NPI Number | 1184508806
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Entity Type | Individual
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Provider Name | PRISICLLA BROWN CHEESEBOROUGH
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 15291 NW 60TH AVE STE 100
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2459
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Country | US
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Telephone | 305-549-8876
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Fax | 305-549-8877
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Provider Business Mailing Address
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Address Line | 3430 NW 188TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-2930
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Country | US
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Telephone | 305-467-0834
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA18915
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License Number State | FL
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