Provider Demographics
NPI:1629236963
Name:DOBOSZ, ANDREA E (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:E
Last Name:DOBOSZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:PUGLIESI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:16 WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6003
Mailing Address - Country:US
Mailing Address - Phone:401-692-7038
Mailing Address - Fax:
Practice Address - Street 1:5830 CORAL RIDGE DR STE 120
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3388
Practice Address - Country:US
Practice Address - Phone:866-425-5768
Practice Address - Fax:888-394-5183
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9026225X00000X
RIOT01270225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist