Provider Demographics
NPI:1578973889
Name:DANG, VAN (OTR)
Entity Type:Individual
Prefix:
First Name:VAN
Middle Name:
Last Name:DANG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7711 NW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2212
Mailing Address - Country:US
Mailing Address - Phone:813-598-8767
Mailing Address - Fax:
Practice Address - Street 1:10100 SW 107TH AVE
Practice Address - Street 2:SECOND FLOOR, EAST WING
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2760
Practice Address - Country:US
Practice Address - Phone:305-598-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 16251225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics