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General NPI Number Information
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NPI Number | 1780704288
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Entity Type | Individual
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Provider Name | CHRISTOPHER MOODY O.T.R/L
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 11845 SW 216 STREET
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City | MIAMI
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State | FL
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Zip | 33170-2938
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Country | US
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Telephone | 786-293-3933
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Fax | 305-378-0078
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Provider Business Mailing Address
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Address Line | 11845 SW 216 STREET
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City | MIAMI
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State | FL
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Zip | 33170-2938
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Country | US
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Telephone | 786-293-3933
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Fax | 305-378-0078
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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 | OT2005
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License Number State | FL
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