Provider Demographics
NPI:1174300164
Name:OTROKHEL LLC
Entity type:Organization
Organization Name:OTROKHEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:ROKHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:646-912-1331
Mailing Address - Street 1:200 SUNNY ISLES BLVD UNIT 503
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4399
Mailing Address - Country:US
Mailing Address - Phone:646-912-1331
Mailing Address - Fax:
Practice Address - Street 1:200 SUNNY ISLES BLVD UNIT 503
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4399
Practice Address - Country:US
Practice Address - Phone:646-912-1331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty