Provider Demographics
NPI:1427274893
Name:MARIN, PATRICIA (OT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:MARIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10105 E CALUSA CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2343
Mailing Address - Country:US
Mailing Address - Phone:305-992-3498
Mailing Address - Fax:305-408-4576
Practice Address - Street 1:10 NW 42ND AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5473
Practice Address - Country:US
Practice Address - Phone:305-567-9194
Practice Address - Fax:305-567-9914
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0412AMedicare ID - Type Unspecified