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Individual

MATTHEW GADDIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
1410 DR MARTIN LUTHER KING JR STREET NORTH, SAFETY HARBOR, FL 43695
(727) 726-1181
Mailing address
1410 DR MARTIN LUTHER KING JR STREET NORTH, SAFETY HARBOR, FL 34695
(727) 726-1181

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15574
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA15574
OTA
FL
Enumeration date
05/24/2019
Last updated
05/24/2019
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