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1700350329
ROBERTO GENARO BANUELAS
WINTER PARK, FL
NPI
1700350329
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA14506)
Enumeration Date
2019-01-16
Last Update Date
2019-01-16
Business Address
ROBERTO GENARO BANUELAS COTA
558 N SEMORAN BLVD
WINTER PARK, FL 32792-2840
Phone number: 407-679-1515
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Mailing Address
ROBERTO GENARO BANUELAS COTA
30021 STATE ROAD 44
EUSTIS, FL 32736-9287
Phone number: 352-818-7720
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