Provider Demographics
NPI:1659482545
Name:MACKEY, BRUCE DOUGLAS (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:DOUGLAS
Last Name:MACKEY
Suffix:
Gender:M
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 1:6511 SW 58TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2001
Mailing Address - Country:US
Mailing Address - Phone:305-661-5670
Mailing Address - Fax:
Practice Address - Street 1:6511 SW 58TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-2001
Practice Address - Country:US
Practice Address - Phone:305-661-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8401225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics