Provider Demographics
NPI:1013280577
Name:ABUATHAREH, ANITA YVONNE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:YVONNE
Last Name:ABUATHAREH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11295 NW 7TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6502
Mailing Address - Country:US
Mailing Address - Phone:786-488-6457
Mailing Address - Fax:786-536-7188
Practice Address - Street 1:9619 FONTAINEBLEAU BLVD APT 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-6869
Practice Address - Country:US
Practice Address - Phone:786-488-6457
Practice Address - Fax:786-536-7188
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOT 15015225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT 15015OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL290904OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.