Provider Demographics
NPI:1477563708
Name:GORSKI, CHRISTINE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:GORSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 51319
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33994-1119
Mailing Address - Country:US
Mailing Address - Phone:239-334-6160
Mailing Address - Fax:239-334-1339
Practice Address - Street 1:1650 MEDICAL LN STE 4
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1116
Practice Address - Country:US
Practice Address - Phone:239-334-6160
Practice Address - Fax:239-334-1339
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12027225X00000X, 222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101549500Medicaid
FL811806000Medicaid
FL811707100Medicaid
FL890750100Medicaid