Provider Demographics
NPI:1326578253
Name:ARENAS, MILDRED (OTR/L)
Entity Type:Individual
Prefix:
First Name:MILDRED
Middle Name:
Last Name:ARENAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MILDRED
Other - Middle Name:
Other - Last Name:ARENAS-GOTTFRIED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2849 LONGLEAF CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3012
Mailing Address - Country:US
Mailing Address - Phone:407-744-1051
Mailing Address - Fax:
Practice Address - Street 1:2849 LONGLEAF CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-3012
Practice Address - Country:US
Practice Address - Phone:407-744-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11467225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist