Provider Demographics
NPI:1568733319
Name:HERRERA, ANDREA MELISSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MELISSA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 NE 23RD ST APT 602
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5069
Mailing Address - Country:US
Mailing Address - Phone:772-240-9346
Mailing Address - Fax:
Practice Address - Street 1:423 NE 23RD ST APT 602
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5069
Practice Address - Country:US
Practice Address - Phone:772-240-9346
Practice Address - Fax:305-675-0855
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
FL15017225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist