Provider Demographics
NPI:1467793562
Name:ABREU, OLGA M (COTA)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:M
Last Name:ABREU
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 S JOHN YOUNG PKWY
Mailing Address - Street 2:SUITE J
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4524
Mailing Address - Country:US
Mailing Address - Phone:407-913-1010
Mailing Address - Fax:
Practice Address - Street 1:3283 S JOHN YOUNG PKWY
Practice Address - Street 2:SUITE J
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4524
Practice Address - Country:US
Practice Address - Phone:407-913-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11405224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA11405OtherFL LICENSE