MEDICARE: NARDIA ALDRIDGE OT

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	225X00000X	Occupational Therapist	012491	NY
2	225X00000X	Occupational Therapist	OT16067	FL

General Provider Information

NPI Number	:	1962739367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARDIA ALDRIDGE OT

Provider Business Mailing Address
First Line	:	12716 NW 20TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7754
Country	:	US
Telephone Number	:	917-280-5359
Fax Number	:

Provider Business Practice Location Address
First Line	:	10426 W ATLANTIC BLVD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5605
Country	:	US
Telephone Number	:	754-702-3704
Fax Number	:

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

Provider Enumeration Date	:	11/06/2009
Last Update Date	:	02/01/2019

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