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General NPI Number Information
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NPI Number | 1275833964
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Entity Type | Individual
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Provider Name | VIRGINIA PACHECO
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Gender | Female
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 454 NW 22ND AVE STE 108
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City | MIAMI
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State | FL
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Zip | 33125-3355
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Country | US
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Telephone | 305-890-9691
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Fax | 305-647-6127
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Provider Business Mailing Address
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Address Line | 60 NW 37TH AVE APT 501
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City | MIAMI
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State | FL
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Zip | 33125-4834
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Country | US
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Telephone | 305-890-9691
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Fax | 305-647-6127
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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 | OT5689
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License Number State | FL
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