Provider Demographics
NPI:1821147273
Name:MASSARD-GALICIA, ERICA (MOTR)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:MASSARD-GALICIA
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8558 GLENCAIRN LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1466
Mailing Address - Country:US
Mailing Address - Phone:305-389-6449
Mailing Address - Fax:305-512-6061
Practice Address - Street 1:1140 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3323
Practice Address - Country:US
Practice Address - Phone:305-558-1203
Practice Address - Fax:305-558-1213
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist