MEDICARE: MRS. DANIELLA PATRICIA BENDIXEN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist	OT21639	FL
2	225XH1200X	Hand Occupational Therapist	OT21639	FL

General Provider Information

NPI Number	:	1083387773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLA PATRICIA BENDIXEN OTR/L

Provider Business Mailing Address
First Line	:	9392 SW 77TH AVE APT E6
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-7958
Country	:	US
Telephone Number	:	305-965-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 SW 37TH AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-2764
Country	:	US
Telephone Number	:	305-642-4263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2021
Last Update Date	:	07/28/2021

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