Provider Demographics
NPI:1871487793
Name:ALFONSO, ANAMARY (OTR)
Entity type:Individual
Prefix:
First Name:ANAMARY
Middle Name:
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ANAMARY
Other - Middle Name:
Other - Last Name:ALFONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:821 W 67TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6464
Mailing Address - Country:US
Mailing Address - Phone:786-366-1833
Mailing Address - Fax:
Practice Address - Street 1:1717 N BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1103
Practice Address - Country:US
Practice Address - Phone:305-749-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA17319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist