Provider Demographics
NPI:1235385212
Name:GAMEZ, MERCEDES (OT)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17920 NW 78TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17670 NW 78TH AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3664
Practice Address - Country:US
Practice Address - Phone:305-512-5757
Practice Address - Fax:305-512-5755
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist