Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT5137 | FL |
N | 225XE0001X | Environmental Modification | OT5137 | FL |
N | 225XF0002X | Feeding, Eating & Swallowing | OT5137 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT5137 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT5137 | FL |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT5137 | FL |
NPI | 1992033278 |
---|---|
Provider Name | Mrs. Gina Perea |
First Address | Bradenton, FL 34209-3952 |
Second Address | Bradenton, FL 34209-3952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2009 |
Last Update Date | 31/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001368300 | (05) | FL |