Active NPI
Polina Fuzaylov
- Occupational Therapy Assistant
- Miami, FL
National Provider Identifier
1366077869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 17386
- Practice address
- 20381 NE 30TH Ave Apt 208
Miami, FL 33180-1521 - Phone
- (646) 326-8981
- NPI assigned
- Mar 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 17386 | FL | Primary |
Addresses
Primary practice location
20381 NE 30TH Ave Apt 208
Miami, FL 33180-1521
Mailing address
20381 NE 30TH Ave Apt 208
Miami, FL 33180-1521
Phone (646) 326-8981
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17386 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1366077869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20381 NE 30TH AVE APT 208",
"city": "MIAMI",
"state": "FL",
"postal_code": "331801521",
"telephone_number": "646-326-8981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20381 NE 30TH AVE APT 208",
"city": "MIAMI",
"state": "FL",
"postal_code": "331801521",
"telephone_number": "646-326-8981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUZAYLOV",
"first_name": "POLINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-05",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "17386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.