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General NPI Number Information
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NPI Number | 1568179349
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Entity Type | Individual
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Provider Name | LUISA OLIVA BOBILLO OTD,OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 12170 W SUNRISE BLVD
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City | PLANTATION
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State | FL
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Zip | 33323-2227
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Country | US
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Telephone | 484-844-0677
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Fax |
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Provider Business Mailing Address
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Address Line | 672 E 21ST ST
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City | HIALEAH
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State | FL
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Zip | 33013-4020
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Country | US
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Telephone | 786-704-4833
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Fax |
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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 | 23599
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License Number State | FL
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