Provider Demographics
NPI:1568415123
Name:KOHN, MICHELLE GVIRA (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GVIRA
Last Name:KOHN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:G
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASTERS
Mailing Address - Street 1:1811 NE 146TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1423
Mailing Address - Country:US
Mailing Address - Phone:305-949-4191
Mailing Address - Fax:
Practice Address - Street 1:1811 NE 146TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1423
Practice Address - Country:US
Practice Address - Phone:305-949-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12004225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYN02JOtherBLUE CROSS BLUE SHIELD
FL891490700Medicaid