Provider Demographics
NPI:1215133343
Name:MCCREA, CHAUNTE T (OTR)
Entity type:Individual
Prefix:MS
First Name:CHAUNTE
Middle Name:T
Last Name:MCCREA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 NW 186TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3310
Mailing Address - Country:US
Mailing Address - Phone:786-277-2570
Mailing Address - Fax:305-687-4588
Practice Address - Street 1:1741 NW 186TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-3310
Practice Address - Country:US
Practice Address - Phone:786-277-2570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
FLOT11897251E00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No251E00000XAgenciesHome Health