Provider Demographics
NPI:1538409867
Name:MIZRAHI, DINA (OTR)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:MIZRAHI
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21300 RUTH AND BARON COLEMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1757
Mailing Address - Country:US
Mailing Address - Phone:954-347-0591
Mailing Address - Fax:
Practice Address - Street 1:21300 RUTH AND BARON COLEMAN BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1757
Practice Address - Country:US
Practice Address - Phone:305-528-7139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-23
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT25944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty