Healthcare Provider Details

I. General information

NPI: 1437555406
Provider Name (Legal Business Name): EMILY GROSSMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N MERIDIAN AVE
MIAMI BEACH FL
33140-2944
US

IV. Provider business mailing address

4539 N MERIDIAN AVE
MIAMI BEACH FL
33140-2944
US

V. Phone/Fax

Practice location:
  • Phone: 305-962-0016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT16547
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: