Provider Demographics
NPI:1114239357
Name:INFANTE, BIANNY (COTA)
Entity Type:Individual
Prefix:MRS
First Name:BIANNY
Middle Name:
Last Name:INFANTE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5979 NW 151ST ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2400
Mailing Address - Country:US
Mailing Address - Phone:786-664-8757
Mailing Address - Fax:305-827-8510
Practice Address - Street 1:5979 NW 151ST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2400
Practice Address - Country:US
Practice Address - Phone:786-664-8757
Practice Address - Fax:305-827-8510
Is Sole Proprietor?:No
Enumeration Date:2010-07-03
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOAT11194224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant