Provider Demographics
NPI:1144332420
Name:AZPEITIA, GYASI (OTR L)
Entity type:Individual
Prefix:
First Name:GYASI
Middle Name:
Last Name:AZPEITIA
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9495 SW 72ND ST # B120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3253
Mailing Address - Country:US
Mailing Address - Phone:786-323-2672
Mailing Address - Fax:786-369-7054
Practice Address - Street 1:9495 SW 72ND ST STE B120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3253
Practice Address - Country:US
Practice Address - Phone:786-332-2672
Practice Address - Fax:786-369-7054
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11017225XH1200X, 225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889784100Medicaid
FL025097100Medicaid