Provider Demographics
NPI:1538451315
Name:WASSERMAN, MIRIAM CARRIE
Entity type:Individual
Prefix:MISS
First Name:MIRIAM
Middle Name:CARRIE
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 W OAKELLAR AVE # 130341
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3114
Mailing Address - Country:US
Mailing Address - Phone:310-944-8743
Mailing Address - Fax:
Practice Address - Street 1:4520 W OAKELLAR AVENUE #130341
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611
Practice Address - Country:US
Practice Address - Phone:310-944-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist