Provider Demographics
NPI:1164511291
Name:GAUDIO, PAULA J (OT, CHT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:GAUDIO
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CLEARFIELD AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1832
Mailing Address - Country:US
Mailing Address - Phone:757-321-3383
Mailing Address - Fax:813-558-6415
Practice Address - Street 1:733 VOLVO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1610
Practice Address - Country:US
Practice Address - Phone:757-321-3300
Practice Address - Fax:577-436-0781
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008016225XH1200X
FLOT1598225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ8490YMedicare PIN
FLZ8490YMedicare PIN