Provider Demographics
NPI:1336995513
Name:MARIN, YAMILE (COTA)
Entity type:Individual
Prefix:
First Name:YAMILE
Middle Name:
Last Name:MARIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 226802
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-6802
Mailing Address - Country:US
Mailing Address - Phone:305-788-3247
Mailing Address - Fax:
Practice Address - Street 1:11231 NW 20TH ST UNIT 139
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-1858
Practice Address - Country:US
Practice Address - Phone:305-552-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19856224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant