Provider Demographics
NPI:1649320086
Name:OCAMPO, LOURDES GIULIANA (OT)
Entity type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:GIULIANA
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 COLLINS AVE
Mailing Address - Street 2:APT #3-D
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2213
Mailing Address - Country:US
Mailing Address - Phone:786-290-6091
Mailing Address - Fax:
Practice Address - Street 1:5825 COLLINS AVE
Practice Address - Street 2:APT #3-D
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2213
Practice Address - Country:US
Practice Address - Phone:786-290-6091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ017QMedicare ID - Type UnspecifiedPROVIDER NO.