=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518212489
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOL ANGELA SIBILIA OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2012
-----------------------------------------------------
Last Update Date | 07/17/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1100 NE 191ST ST APARTMENT E23
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-423-8523
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1100 NE 191ST ST APARTMENT E23
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-423-8523
-----------------------------------------------------
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 | 14517
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------