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General NPI Number Information
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NPI Number | 1962960781
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Entity Type | Individual
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Provider Name | CARA REBECCA GILISON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 4246 W HIGHWAY 318
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City | CITRA
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State | FL
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Zip | 32113-2141
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Country | US
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Telephone | 904-540-5853
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 ANDERSON ST
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-3741
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Country | US
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Telephone | 904-540-5853
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Fax | 904-781-8191
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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 | 19261
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License Number State | FL
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