Provider Demographics
NPI:1295030070
Name:BERMEO, ERIKA (OT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:BERMEO
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 1:1462 SW 145TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3130
Mailing Address - Country:US
Mailing Address - Phone:786-543-0675
Mailing Address - Fax:
Practice Address - Street 1:14291 SW 120TH ST
Practice Address - Street 2:STE #103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7286
Practice Address - Country:US
Practice Address - Phone:305-385-0168
Practice Address - Fax:305-385-0182
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14469225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist