Provider Demographics
NPI:1205106051
Name:FERNANDEZ DE CASTRO, KAREN IVETTE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:IVETTE
Last Name:FERNANDEZ DE CASTRO
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 1:756 WEST PALM DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034
Mailing Address - Country:US
Mailing Address - Phone:305-246-3530
Mailing Address - Fax:305-246-4585
Practice Address - Street 1:756 WEST PALM DRIVE
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034
Practice Address - Country:US
Practice Address - Phone:305-246-3530
Practice Address - Fax:305-246-4585
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13343225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist