Provider Demographics
NPI:1922115518
Name:JORGE, MARIA DE LOS ANGELES (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:JORGE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9756 NW 51ST TERR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:305-994-7337
Mailing Address - Fax:305-585-6007
Practice Address - Street 1:1611 NW 12 TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-7224
Practice Address - Fax:305-585-6007
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1078225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics