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General NPI Number Information
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NPI Number | 1952965162
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Entity Type | Individual
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Provider Name | ASHLEY GORTLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 17901 NW 5TH ST STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2810
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Country | US
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Telephone | 954-606-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 SW 31ST ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33315-2928
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Country | US
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Telephone | 954-806-0740
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT18267
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License Number State | FL
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