Provider Demographics
NPI:1477609113
Name:SAMEL, EILEEN BARBARA (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:BARBARA
Last Name:SAMEL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 NW 138TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-3030
Mailing Address - Country:US
Mailing Address - Phone:954-447-9328
Mailing Address - Fax:
Practice Address - Street 1:1412 NW 138TH TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-3030
Practice Address - Country:US
Practice Address - Phone:954-447-9328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist