Integration OT in Pediatrics

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

4403 Issued in FL

Legal business name

INTEGRATION OT IN PEDIATRICS

Practice address

701 Brickell Key Blvd
1607
Miami, FL 33131-2674

Phone

(786) 510-0814

Fax

(305) 359-9261

NPI assigned

Mar 26, 2014

Last updated

Mar 26, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Marcelle Horn-Mandiola, OTR

Title

Occupational Therapist

Phone

(786) 510-0814

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1164849394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BRICKELL KEY BLVD",
            "address_2": "1607",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312674",
            "telephone_number": "786-510-0814",
            "fax_number": "305-359-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BRICKELL KEY BLVD",
            "address_2": "1607",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312674",
            "telephone_number": "786-510-0814",
            "fax_number": "305-359-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATION OT IN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "HORN-MANDIOLA",
        "authorized_official_first_name": "MARCELLE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "786-510-0814",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "4403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004591600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.