Provider Demographics
NPI:1568675478
Name:PEREZ- ORTUNO, LETICIA
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:PEREZ- ORTUNO
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 1:2217 NW 7TH ST
Mailing Address - Street 2:APT 1001
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3330
Mailing Address - Country:US
Mailing Address - Phone:305-665-4999
Mailing Address - Fax:305-665-0332
Practice Address - Street 1:2217 NW 7TH ST
Practice Address - Street 2:APT 1001
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3330
Practice Address - Country:US
Practice Address - Phone:305-665-4999
Practice Address - Fax:305-665-0332
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist