Active NPI
Mely Marie Gamba-Rivera, COTA/L
- Occupational Therapy Assistant
- Hialeah, FL
National Provider Identifier
1508093170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA 10491
- Practice address
- 17670 NW 78TH Ave
Suite 113
Hialeah, FL 33015-3664 - Phone
- (305) 512-5757
- Fax
- (305) 512-5755
- NPI assigned
- Jun 22, 2009
- 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 | OTA 10491 | FL | Primary |
Addresses
Primary practice location
17670 NW 78TH Ave
Suite 113
Hialeah, FL 33015-3664
Mailing address
6600 Cypress Rd
Unit 512
Plantation, FL 33317-3092
Phone (954) 655-1461
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 |
|---|---|---|---|
| OTA 10491 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1508093170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 CYPRESS RD",
"address_2": "UNIT 512",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333173092",
"telephone_number": "954-655-1461",
"fax_number": "305-512-5755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17670 NW 78TH AVE",
"address_2": "SUITE 113",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330153664",
"telephone_number": "305-512-5757",
"fax_number": "305-512-5755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBA-RIVERA",
"first_name": "MELY",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-22",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA 10491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.