Healthcare Provider Details

I. General information

NPI: 1336719574
Provider Name (Legal Business Name): CHRISTINA MARIE FORSBERG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3156 NORTHSIDE DR
KEY WEST FL
33040-8024
US

IV. Provider business mailing address

3156 NORTHSIDE DR
KEY WEST FL
33040-8024
US

V. Phone/Fax

Practice location:
  • Phone: 808-293-2830
  • Fax: 808-593-2840
Mailing address:
  • Phone: 262-420-8804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number26-1426657
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: