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General NPI Number Information
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NPI Number | 1649382847
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Entity Type | Individual
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Provider Name | MARIO REY OTR
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 06/03/2017
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Provider Practice Location Address
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Address Line | 456 W 51ST PL
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City | HIALEAH
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State | FL
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Zip | 33012-3620
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Country | US
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Telephone | 305-819-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 5765 SW 116 AVE
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City | MIAMI
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State | FL
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Zip | 33173
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Country | US
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Telephone | 786-271-6573
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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 | OT-12196
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License Number State | FL
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