Provider Demographics
NPI:1669546461
Name:ALI, MOHAMED A (OT)
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:A
Last Name:ALI
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13757 HUNTWICK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5515
Mailing Address - Country:US
Mailing Address - Phone:407-962-9613
Mailing Address - Fax:407-803-7833
Practice Address - Street 1:13757 HUNTWICK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-5515
Practice Address - Country:US
Practice Address - Phone:407-962-9613
Practice Address - Fax:407-803-7833
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12259225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist