Provider Demographics
NPI:1306824206
Name:FELDMAN, LISA GEMA (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GEMA
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3553 NW 25TH WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3415
Mailing Address - Country:US
Mailing Address - Phone:561-482-1315
Mailing Address - Fax:561-482-1315
Practice Address - Street 1:3066 JOG RD
Practice Address - Street 2:ADVANCED PEDIATRIC SYSTEMS
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2053
Practice Address - Country:US
Practice Address - Phone:561-357-5883
Practice Address - Fax:561-357-5884
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7485225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist