Provider Demographics
NPI:1194166546
Name:DELGADO, ALICIA MICHELE (OTR/L)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MICHELE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:BRIMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10633 SW 129TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3551
Mailing Address - Country:US
Mailing Address - Phone:786-554-8920
Mailing Address - Fax:
Practice Address - Street 1:21520 SW 97TH PL
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3718
Practice Address - Country:US
Practice Address - Phone:786-554-8920
Practice Address - Fax:786-661-4862
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist