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NPI Code Detail

MEDICARE: KATHRYN PAIGE GOGARTY OTR

MEDICARE: KATHRYN PAIGE GOGARTY OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT18974FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G263515796040OTHERFLDRIVER LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699275156
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN PAIGE GOGARTY OTR
Provider Business Mailing Address
First Line : 9373 FONTAINEBLEAU BLVD APT K208
Second Line :
City : MIAMI
State : FL
Zip : 33172-5698
Country : US
Telephone Number : 786-290-6206
Fax Number :
Provider Business Practice Location Address
First Line : 5580 W 16TH AVE STE 201
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2189
Country : US
Telephone Number : 305-456-2646
Fax Number : 305-967-8442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2018
Last Update Date : 02/20/2018

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