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General NPI Number Information
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NPI Number | 1275216913
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Entity Type | Individual
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Provider Name | EVAN HARLEY SUMMERS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 1893 NE MIAMI GARDENS DR
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-5035
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Country | US
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Telephone | 305-682-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 20741 NE 19TH CT
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-2249
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Country | US
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Telephone | 305-924-4991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 24500
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License Number State | FL
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