Provider Demographics
NPI:1184916926
Name:QUITTNER, SHELLEY (OTR)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:QUITTNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 SW 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5058
Mailing Address - Country:US
Mailing Address - Phone:954-647-0078
Mailing Address - Fax:954-581-2683
Practice Address - Street 1:1351 SW 69TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-5058
Practice Address - Country:US
Practice Address - Phone:954-647-0078
Practice Address - Fax:954-581-2683
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL000234225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics