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General NPI Number Information
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NPI Number | 1366165615
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Entity Type | Individual
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Provider Name | ANGELINE TILUS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 1580 SAWGRASS CORPORATE PKWY STE 200
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City | SUNRISE
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State | FL
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Zip | 33323-2869
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Country | US
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Telephone | 954-833-0518
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 NW 7TH TER
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-6001
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Country | US
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Telephone | 954-817-4224
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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 | 26258
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 23554
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License Number State | FL
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