=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407017619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAMMIE GURSKY OCCUPATIONAL THERAPY PLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2008
-----------------------------------------------------
Last Update Date | 06/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8916 PROVINCE ST
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34240-8311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-377-1053
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8916 PROVINCE ST
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34240-8311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-377-1053
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MS/OTR/L
-----------------------------------------------------
Name | MS. TAMMIE L. GURSKY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 941-377-1053
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT12808
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------