Provider Demographics
NPI:1336756584
Name:BRAHA, ADI (OTR/L)
Entity Type:Individual
Prefix:
First Name:ADI
Middle Name:
Last Name:BRAHA
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 1:2600 ISLAND BLVD APT 2501
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-5211
Mailing Address - Country:US
Mailing Address - Phone:954-240-4300
Mailing Address - Fax:
Practice Address - Street 1:15291 NW 60TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2459
Practice Address - Country:US
Practice Address - Phone:305-705-7702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21169225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist