Organization
PROVIDENCE PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS HANNAH NICOLE BERGE OTR/L (OCCUPATIONAL THERAPIST)
(815) 505-5545
Entity
Organization
Contact information
Practice address
7616 W COURTNEY CAMPBELL CSWY UNIT 210, TAMPA, FL 33607-1533
(815) 505-5545
Mailing address
7616 W COURTNEY CAMPBELL CSWY UNIT 210, TAMPA, FL 33607-1533
(815) 505-5545
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT20551
—
FL
Enumeration date
04/06/2021
Last updated
09/11/2025
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