Provider Demographics
NPI:1841071107
Name:PEREIRA-OLIVERA, YAIMIS LIUBIS (OTR)
Entity type:Individual
Prefix:
First Name:YAIMIS
Middle Name:LIUBIS
Last Name:PEREIRA-OLIVERA
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 1:15545 MIAMI LAKEWAY N
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7500
Mailing Address - Country:US
Mailing Address - Phone:786-738-4520
Mailing Address - Fax:
Practice Address - Street 1:15545 MIAMI LAKEWAY N
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7500
Practice Address - Country:US
Practice Address - Phone:786-738-4520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT23343225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT23343OtherLICENSE