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General NPI Number Information
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NPI Number | 1619597028
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Entity Type | Individual
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Provider Name | AGNIESZKA MARTA GOLDWASER OT
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Gender | Female
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 04/26/2020
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Provider Practice Location Address
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Address Line | 7225 BOCA DEL MAR DR
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City | BOCA RATON
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State | FL
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Zip | 33433-5517
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Country | US
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Telephone | 561-362-9644
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Fax |
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Provider Business Mailing Address
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Address Line | 8897 RAVEN ROCK CT
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-4831
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Country | US
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Telephone | 954-249-4207
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 9880
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License Number State | FL
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