Individual
WILSON GILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2000 N SEMORAN BLVD, ORLANDO, FL 32807-3712
(407) 671-5400
Mailing address
2382 LAUREL BLOSSOM CIR, OCOEE, FL 34761-5202
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12562
FL
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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