Provider Demographics
NPI:1962389940
Name:LEM, AUDREY (OTR)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:LEM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 NE 160TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4341
Mailing Address - Country:US
Mailing Address - Phone:786-260-7582
Mailing Address - Fax:786-260-7582
Practice Address - Street 1:1005 NW 79TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-3141
Practice Address - Country:US
Practice Address - Phone:305-756-9947
Practice Address - Fax:305-756-9948
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT26418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty