Provider Demographics
NPI:1649931346
Name:MARCELIN, DALPH G (COTA/L)
Entity type:Individual
Prefix:
First Name:DALPH
Middle Name:G
Last Name:MARCELIN
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 BISCAYNE BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3449
Mailing Address - Country:US
Mailing Address - Phone:407-600-3524
Mailing Address - Fax:
Practice Address - Street 1:11200 BISCAYNE BLVD APT 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3449
Practice Address - Country:US
Practice Address - Phone:407-600-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty