Active NPI
Mariela Ines Miccio
- Developmental Therapist
- Fort Lauderdale, FL
National Provider Identifier
1497163570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 6160 SW 195TH Ave
Fort Lauderdale, FL 33332-3391 - Phone
- (786) 348-6957
- NPI assigned
- Aug 1, 2014
- Last updated
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA13468 | FL | |
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
6160 SW 195TH Ave
Fort Lauderdale, FL 33332-3391
Mailing address
6160 SW 195TH Ave
Fort Lauderdale, FL 33332-3391
Phone (786) 348-6957
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 |
|---|---|---|---|
| OTA13468 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1497163570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6160 SW 195TH AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333323391",
"telephone_number": "786-348-6957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6160 SW 195TH AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333323391",
"telephone_number": "786-348-6957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICCIO",
"first_name": "MARIELA",
"middle_name": "INES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-01",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA13468",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
- Brett Olen Meyer, LMT
- Scott Meyer, MD
- Heidi Meyers
- MHC Area 10, LLC (Choice Health at Home)
- Miami Road Opco LLC (Aviata at the Sea - Harbor Beach)
- Michael a Chizner MD PA
- Michael B Blum DMD PA (Center for the Dental Arts)
- Michael Barnard DDS PA
- Michael Bettencourt LCSW LLC
- Michael C. Cheung, M.D., P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.