Provider Demographics
NPI:1013379213
Name:AHOUNOU, KAZIM (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAZIM
Middle Name:
Last Name:AHOUNOU
Suffix:
Gender:M
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 1:10416 VISTA GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4238
Mailing Address - Country:US
Mailing Address - Phone:813-965-4387
Mailing Address - Fax:
Practice Address - Street 1:5860 E JUNIOR COLLEGE RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4314
Practice Address - Country:US
Practice Address - Phone:305-296-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-26
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07920225X00000X
FL344678225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist