Provider Demographics
NPI:1255966479
Name:HORTA, ROSELIA MARIA (OTR)
Entity type:Individual
Prefix:
First Name:ROSELIA
Middle Name:MARIA
Last Name:HORTA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6720
Mailing Address - Country:US
Mailing Address - Phone:954-443-1926
Mailing Address - Fax:954-443-1936
Practice Address - Street 1:454 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6720
Practice Address - Country:US
Practice Address - Phone:954-443-1926
Practice Address - Fax:954-443-1936
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2820225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist