Healthcare Provider Details

I. General information

NPI: 1881786994
Provider Name (Legal Business Name): PAMELA ANN KASYAN-ITZKOWITZ MS, OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

11365 NW 18TH CT
PLANTATION FL
33323-2217
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-1233
  • Fax:
Mailing address:
  • Phone: 954-476-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 7925
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT 7925
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: