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NPI Code Detail

MEDICARE: MILDRED ENID MARRERO OTR

MEDICARE:   MILDRED ENID MARRERO  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
1225X00000XOccupational TherapistOT11933FL

General Provider Information

NPI Number : 1710829031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILDRED ENID MARRERO OTR
Provider Business Mailing Address
First Line : 587 BARTON BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3145
Country : US
Telephone Number : 321-632-6300
Fax Number :
Provider Business Practice Location Address
First Line : 587 BARTON BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3145
Country : US
Telephone Number : 321-632-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ MILDRED ENID MARRERO OTR” Practice Location

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