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General NPI Number Information
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NPI Number | 1902885064
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Entity Type | Individual
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Provider Name | MARTHA J CARLSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 1605 NW 36TH WAY
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City | GAINESVILLE
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State | FL
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Zip | 32605-4854
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Country | US
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Telephone | 352-359-0043
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Fax | 352-371-0355
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Provider Business Mailing Address
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Address Line | 1605 NW 36TH WAY
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City | GAINESVILLE
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State | FL
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Zip | 32605-4854
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Country | US
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Telephone | 352-359-0043
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Fax | 352-371-0355
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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 | FL OT 0628
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License Number State | FL
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