Provider Demographics
NPI:1407493000
Name:PEREZ BELTRE, ZUSELLE STEPHANIE
Entity Type:Individual
Prefix:
First Name:ZUSELLE
Middle Name:STEPHANIE
Last Name:PEREZ BELTRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 S RIO GRANDE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4650
Mailing Address - Country:US
Mailing Address - Phone:407-280-3776
Mailing Address - Fax:407-454-9007
Practice Address - Street 1:6000 S RIO GRANDE AVE STE 206
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4650
Practice Address - Country:US
Practice Address - Phone:407-280-3776
Practice Address - Fax:407-454-9007
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16685224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA16685OtherFLORIDA DEPARTMENT OF HEALTH