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General NPI Number Information
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NPI Number | 1942609417
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Entity Type | Individual
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Provider Name | YUICSES CACERES OTA12365
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Gender | Female
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4365 NW 170TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-4328
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Country | US
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Telephone | 305-632-4056
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Fax |
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Provider Business Mailing Address
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Address Line | 8545 NW 198TH TER
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City | HIALEAH
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State | FL
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Zip | 33015-6957
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Country | US
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Telephone | 305-988-5651
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTA12365
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License Number State | FL
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