Provider Demographics
NPI:1851640205
Name:ROBLETO, MARIAM M (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:M
Last Name:ROBLETO
Suffix:
Gender:F
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 1:336 SE 37TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-6251
Mailing Address - Country:US
Mailing Address - Phone:305-788-2180
Mailing Address - Fax:
Practice Address - Street 1:9415 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5427
Practice Address - Country:US
Practice Address - Phone:786-507-4278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 12371261QX0100X
FLOT21951225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine