=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518200815
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIUDMILA CAMEJO ROJAS OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2013
-----------------------------------------------------
Last Update Date | 04/10/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9733 NW 41ST ST
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33178-2944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-506-1112
-----------------------------------------------------
Fax | 786-233-2334
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9733 NW 41ST ST
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33178-2944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-597-5209
-----------------------------------------------------
Fax | 305-597-5474
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0019X
-----------------------------------------------------
Taxonomy Name | Physical Rehabilitation Occupational Therapist
-----------------------------------------------------
License Number | OT 13107
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------