Provider Demographics
NPI:1588067821
Name:GASPARRO, VITO (OTA)
Entity type:Individual
Prefix:
First Name:VITO
Middle Name:
Last Name:GASPARRO
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 SW 72ND ST
Mailing Address - Street 2:9425 SW 72 STREET SUITE 261
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3251
Mailing Address - Country:US
Mailing Address - Phone:305-271-7949
Mailing Address - Fax:305-271-7949
Practice Address - Street 1:9425 SW 72ND ST STE 261
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5457
Practice Address - Country:US
Practice Address - Phone:305-271-7343
Practice Address - Fax:305-271-7949
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 13908224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA 13908OtherDEPARTMENT OF HEALTH PROFESSIONS-OCCUPATIONAL THERAPY ASSISTANT