MEDICARE: NATALIJA AHO

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
1	224Z00000X	Occupational Therapy Assistant	13077	FL
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1780096065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIJA AHO

Provider Business Mailing Address
First Line	:	1919 SE 10TH AVE
Second Line	:	APT 1116
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-940-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 SE 10TH AVE
Second Line	:	1116
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-940-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	10/28/2019

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