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General NPI Number Information
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NPI Number | 1417493974
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Entity Type | Organization
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Legal Business Name | HORSE THERAPY CONNECTION INC
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 6000 SW 123RD AVE
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City | MIAMI
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State | FL
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Zip | 33183-1530
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Country | US
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Telephone | 786-546-0403
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Fax |
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Provider Business Mailing Address
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Address Line | 17275 COLLINS AVE UNIT 505
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3441
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Country | US
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Telephone | 786-546-0403
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. FABIANA MARTIN
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Credential | MS, OTR/L
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Telephone | 786-546-0403
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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 | OT15207
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License Number State | FL
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