Provider Demographics
NPI:1316540131
Name:CACERES, YARITZA ESTRELLA (OTR/L)
Entity Type:Individual
Prefix:
First Name:YARITZA
Middle Name:ESTRELLA
Last Name:CACERES
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 1:10045 NW 28TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1333
Mailing Address - Country:US
Mailing Address - Phone:786-473-3906
Mailing Address - Fax:
Practice Address - Street 1:6862 NW 169TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4210
Practice Address - Country:US
Practice Address - Phone:786-615-8426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20810225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty