Healthcare Provider Details

I. General information

NPI: 1326772039
Provider Name (Legal Business Name): CAMERON GEHRKE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8677 ADDISON PLACE CIR UNIT 302
NAPLES FL
34119-7868
US

IV. Provider business mailing address

8677 ADDISON PLACE CIR UNIT 302
NAPLES FL
34119-7868
US

V. Phone/Fax

Practice location:
  • Phone: 239-392-1070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT23160
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: