Provider Demographics
NPI:1366334898
Name:PUPO, VLADIMIR O
Entity type:Individual
Prefix:MR
First Name:VLADIMIR
Middle Name:O
Last Name:PUPO
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 1:2555 COLLINS AVE STE C-10
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4723
Mailing Address - Country:US
Mailing Address - Phone:786-972-7099
Mailing Address - Fax:
Practice Address - Street 1:2555 COLLINS AVE STE C-10
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4723
Practice Address - Country:US
Practice Address - Phone:786-972-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT22892225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist