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Individual

MRS. ANITA MARIE DAVID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1636 NW 5TH AVE, FORT LAUDERDALE, FL 33311-5508
(954) 865-3705
(954) 204-0014
Mailing address
1636 NW 5TH AVE, FORT LAUDERDALE, FL 33311-5508
(954) 865-3705
(954) 204-0014

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
11518
FL
225X00000X
Occupational Therapist
Primary
OT 11518
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010042600
FL
05
891985200
FL
Enumeration date
09/15/2006
Last updated
09/08/2016
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