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NPI 1578836839

NPI 1578836839 : ANA SOLIS PEDIATRIC OCCUPATIONAL THERAPY : MIRAMAR, FL

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General NPI Number Information
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    NPI Number           |    1578836839
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANA SOLIS PEDIATRIC OCCUPATIONAL THERAPY 
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Dates
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    Enumeration Date     |    02/17/2012
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    Last Update Date     |    02/17/2012
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Provider Practice Location Address
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    Address Line         |    19509 SW 54TH ST 
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    City                 |    MIRAMAR
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    State                |    FL
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    Zip                  |    33029-6272
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    Country              |    US
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    Telephone            |    954-499-8727
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    19509 SW 54TH ST 
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    City                 |    MIRAMAR
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    State                |    FL
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    Zip                  |    33029-6272
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    Country              |    US
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    Telephone            |    954-499-8727
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. ANA MARIA SOLIS 
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    Credential           |    OTR
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    Telephone            |    954-499-8727
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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       |    3070
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    License Number State |    FL
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