Healthcare Provider Details
I. General information
NPI: 1386978625
Provider Name (Legal Business Name): CRYSTAL GAIL ZILINSKI MS, OTL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/18/2009
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2669 ENTERPRISE RD
ORANGE CITY FL
32763-8217
US
IV. Provider business mailing address
2669 ENTERPRISE RD
ORANGE CITY FL
32763-8217
US
V. Phone/Fax
- Phone: 321-233-3534
- Fax:
- Phone: 321-233-3534
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | 46TR00261700 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OT25244 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: