MEDICARE: MARIO REY OTR

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	225X00000X	Occupational Therapist	OT-12196	FL

General Provider Information

NPI Number	:	1649382847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIO REY OTR

Provider Business Mailing Address
First Line	:	5765 SW 116 AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173
Country	:	US
Telephone Number	:	786-271-6573
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 W 51ST PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3620
Country	:	US
Telephone Number	:	305-819-7770
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	06/03/2017

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Directions to “ MARIO REY OTR” Practice Location

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