Provider Demographics
NPI:1326168121
Name:POLI, ORIETTA BRENDA (OTR)
Entity Type:Individual
Prefix:
First Name:ORIETTA
Middle Name:BRENDA
Last Name:POLI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14476 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6841
Mailing Address - Country:US
Mailing Address - Phone:305-992-2320
Mailing Address - Fax:305-256-4277
Practice Address - Street 1:14476 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6841
Practice Address - Country:US
Practice Address - Phone:305-992-2320
Practice Address - Fax:305-256-4277
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11117225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist