Provider Demographics
NPI:1255689196
Name:PERDOMO, YRMA LADY (OTR/L)
Entity Type:Individual
Prefix:
First Name:YRMA
Middle Name:LADY
Last Name:PERDOMO
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 1:275 NE 18TH ST
Mailing Address - Street 2:PH7
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1117
Mailing Address - Country:US
Mailing Address - Phone:718-207-1848
Mailing Address - Fax:
Practice Address - Street 1:275 NE 18TH ST
Practice Address - Street 2:PH7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1117
Practice Address - Country:US
Practice Address - Phone:718-207-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 15290225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist