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General NPI Number Information
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NPI Number | 1346619756
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Entity Type | Individual
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Provider Name | ELANA ROSE RIEDERMAN MS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 551 NW 77TH ST STE 111
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City | BOCA RATON
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State | FL
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Zip | 33487
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Country | US
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Telephone | 888-846-0652
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Fax |
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Provider Business Mailing Address
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Address Line | 4918 SAND STONE LN APT 102
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-7506
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Country | US
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Telephone | 847-347-9601
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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 |
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License Number State |
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