Healthcare Provider Details

I. General information

NPI: 1871819581
Provider Name (Legal Business Name): SVETLANA GELMAN BUCHALTER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 E SHERIDAN ST
DANIA BEACH FL
33004-4603
US

IV. Provider business mailing address

427 E SHERIDAN ST
DANIA BEACH FL
33004-4603
US

V. Phone/Fax

Practice location:
  • Phone: 954-536-1315
  • Fax:
Mailing address:
  • Phone: 954-536-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT13623
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: