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NPI Code Detail

MEDICARE: MRS. LISA GEMA FELDMAN OTRL

MEDICARE: MRS. LISA GEMA FELDMAN OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT7485FL

General Provider Information

NPI Number : 1306824206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA GEMA FELDMAN OTRL
Provider Business Mailing Address
First Line : 3553 NW 25TH WAY
Second Line :
City : BOCA RATON
State : FL
Zip : 33434-3415
Country : US
Telephone Number : 561-482-1315
Fax Number : 561-482-1315
Provider Business Practice Location Address
First Line : 3066 JOG RD
Second Line : ADVANCED PEDIATRIC SYSTEMS
City : GREENACRES
State : FL
Zip : 33467-2053
Country : US
Telephone Number : 561-357-5883
Fax Number : 561-357-5884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 07/08/2007

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