MEDICARE: SARAH OTERO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1710270582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH OTERO

Provider Business Mailing Address
First Line	:	16201 NE 13TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	786-955-6224
Fax Number	:

Provider Business Practice Location Address
First Line	:	16201 NE 13TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4607
Country	:	US
Telephone Number	:	786-955-6224
Fax Number	:

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

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	10/21/2019

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Directions to “ SARAH OTERO ” Practice Location

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