Provider Demographics
NPI:1083253108
Name:URENA, PAMELA PAOLA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:PAOLA
Last Name:URENA
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 1:155 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5961
Mailing Address - Country:US
Mailing Address - Phone:407-201-1872
Mailing Address - Fax:
Practice Address - Street 1:2013 LIVE OAK BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8410
Practice Address - Country:US
Practice Address - Phone:321-805-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor