Provider Demographics
NPI:1124241773
Name:LASAGNA, MARIA SOLEDAD (OTR,L)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:SOLEDAD
Last Name:LASAGNA
Suffix:
Gender:F
Credentials:OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13540 SW 108TH STREET CIR N
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3349
Mailing Address - Country:US
Mailing Address - Phone:786-556-6222
Mailing Address - Fax:
Practice Address - Street 1:13540 SW 108TH STREET CIR N
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-3349
Practice Address - Country:US
Practice Address - Phone:786-556-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887034900Medicaid