Provider Demographics
NPI:1700616653
Name:BATTLE, VENTRELL MAURICE
Entity type:Individual
Prefix:
First Name:VENTRELL
Middle Name:MAURICE
Last Name:BATTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20491 NW 12TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2486
Mailing Address - Country:US
Mailing Address - Phone:786-546-6829
Mailing Address - Fax:
Practice Address - Street 1:20491 NW 12TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2486
Practice Address - Country:US
Practice Address - Phone:786-546-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant