Healthcare Provider Details

I. General information

NPI: 1124175823
Provider Name (Legal Business Name): ENID GILDAR, MA, CCC,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8019 N HIMES AVE SUITE 300
TAMPA FL
33614-2712
US

IV. Provider business mailing address

8019 N HIMES AVE SUITE 300
TAMPA FL
33614-2712
US

V. Phone/Fax

Practice location:
  • Phone: 813-933-7300
  • Fax: 813-933-3550
Mailing address:
  • Phone: 813-933-7300
  • Fax: 813-933-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberSA235
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA235
License Number StateFL

VIII. Authorized Official

Name: ENID STALLER GILDAR
Title or Position: OWNER
Credential: M.A., CCC
Phone: 813-933-7300