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NPI Code Detail

MEDICARE: THALIA DUARTE OT

MEDICARE: THALIA DUARTE OT
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
1106S00000XBehavior TechnicianTX
2225X00000XOccupational Therapist119288TX

General Provider Information

NPI Number : 1881192706
Entity Type Code : Individual
Provider Name (Legal Business Name) : THALIA DUARTE OT
Provider Business Mailing Address
First Line : 6416 NW 5TH WAY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-6112
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-982-6491
Provider Business Practice Location Address
First Line : 20601 N 19TH AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-2666
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-982-6491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2018
Last Update Date : 03/02/2022

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Directions to “ THALIA DUARTE OT” Practice Location

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