Provider Demographics
NPI:1538625959
Name:LACERIA, VERONICA (OTR/L)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LACERIA
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 1:10737 S PRESERVE WAY APT 202
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6557
Mailing Address - Country:US
Mailing Address - Phone:954-806-7140
Mailing Address - Fax:
Practice Address - Street 1:3575 NE 207TH ST STE B17
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-3705
Practice Address - Country:US
Practice Address - Phone:305-306-8376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist