Provider Demographics
NPI:1275682312
Name:PEREZ, GLORIA ZELAYA (OT)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:ZELAYA
Last Name:PEREZ
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 1:12490 NW 11TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2435
Mailing Address - Country:US
Mailing Address - Phone:305-207-3594
Mailing Address - Fax:
Practice Address - Street 1:12490 NW 11TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-2435
Practice Address - Country:US
Practice Address - Phone:305-207-3594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11963225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist