Provider Demographics
NPI:1962756692
Name:CASAS, REBECCA ALEXANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALEXANDRA
Last Name:CASAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3651
Mailing Address - Country:US
Mailing Address - Phone:954-372-9710
Mailing Address - Fax:
Practice Address - Street 1:2685 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 5
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3651
Practice Address - Country:US
Practice Address - Phone:954-372-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 15492225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics