Provider Demographics
NPI:1821288382
Name:VAN DER BIEST, DELIA R (OTR)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:R
Last Name:VAN DER BIEST
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 1:7909 EAST DR APT 204
Mailing Address - Street 2:
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3336
Mailing Address - Country:US
Mailing Address - Phone:305-389-0495
Mailing Address - Fax:
Practice Address - Street 1:601 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3209
Practice Address - Country:US
Practice Address - Phone:305-389-0495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12199225X00000X
FLOT12199225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision