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General NPI Number Information
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NPI Number | 1952980583
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Entity Type | Individual
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Provider Name | NYLAH DARLENE LUMMER ORT/L
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 520 NW 165TH ST STE 205
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City | MIAMI
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State | FL
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Zip | 33169-6343
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Country | US
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Telephone | 786-623-4053
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 S OCEAN DR APT 16C
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5969
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Country | US
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Telephone | 707-486-2523
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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 | 21733
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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 | 17497
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 17497
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 21733
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License Number State | FL
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