Provider Demographics
NPI:1972835817
Name:MIGUEZ, OVIDE J (OT)
Entity Type:Individual
Prefix:
First Name:OVIDE
Middle Name:J
Last Name:MIGUEZ
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 SW 6TH CT
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-3020
Mailing Address - Country:US
Mailing Address - Phone:954-632-8018
Mailing Address - Fax:
Practice Address - Street 1:5160 SW 6TH CT
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-3020
Practice Address - Country:US
Practice Address - Phone:954-632-8018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10324225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist