MEDICARE: MRS. SANDRA MAYANS OTA/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	174400000X	Specialist	OTA 10934	FL

General Provider Information

NPI Number	:	1649505389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA MAYANS OTA/L

Provider Business Mailing Address
First Line	:	9000 SW 137TH AVE STE 116
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-1435
Country	:	US
Telephone Number	:	305-382-9991
Fax Number	:	305-382-9550

Provider Business Practice Location Address
First Line	:	9000 SW 137TH AVE STE 116
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-1435
Country	:	US
Telephone Number	:	305-382-9991
Fax Number	:	305-382-9550

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

Provider Enumeration Date	:	10/14/2009
Last Update Date	:	10/14/2009

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Directions to “ MRS. SANDRA MAYANS OTA/L” Practice Location

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