Healthcare Provider Details

I. General information

NPI: 1215562731
Provider Name (Legal Business Name): GABRIELLE IVONNE TORRE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 S JOG RD STE 100
DELRAY BEACH FL
33446-3808
US

IV. Provider business mailing address

13550 S JOG RD STE 100
DELRAY BEACH FL
33446-3808
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-5144
  • Fax: 561-496-5201
Mailing address:
  • Phone: 561-496-5144
  • Fax: 561-496-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT20574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: