=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245712637
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MIRYAM STEPHANI ARRIOLA OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2018
-----------------------------------------------------
Last Update Date | 08/31/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19301 SW 87TH AVE
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-8904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-256-3578
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11334 SW 70TH TER
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33173-1910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-351-0326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 18819
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------