Provider Demographics
NPI:1619316015
Name:BIRRO-ANJOS, PRISCILA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILA
Middle Name:
Last Name:BIRRO-ANJOS
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 1:22169 SW 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4537
Mailing Address - Country:US
Mailing Address - Phone:561-289-7746
Mailing Address - Fax:
Practice Address - Street 1:660 GLADES RD STE 460
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6469
Practice Address - Country:US
Practice Address - Phone:561-391-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 15723225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist