Individual provider Active NPI

Marisol Vanga

  • Occupational Therapy Assistant
  • Hollywood, FL
National Provider Identifier
1124322862
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA11426 Issued in FL
Practice address
1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937
Phone
(954) 925-3844
Fax
(954) 925-3845
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA11426 FL Primary

Addresses

Primary practice location

1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937

Mailing address

2621 NW 5TH St
Pompano Beach, FL 33069-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA11426FLMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1124322862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 NW 5TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330692273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKWOOD BLVD STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201937",
            "telephone_number": "954-925-3844",
            "fax_number": "954-925-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGA",
        "first_name": "MARISOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA11426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.