Provider Demographics
NPI:1104139427
Name:SPIRA, GEELA (OT)
Entity type:Individual
Prefix:MRS
First Name:GEELA
Middle Name:
Last Name:SPIRA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:GEELA
Other - Middle Name:
Other - Last Name:SPIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:5874 CRYSTAL SHORES DR
Mailing Address - Street 2:#208
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-5683
Mailing Address - Country:US
Mailing Address - Phone:954-465-2034
Mailing Address - Fax:
Practice Address - Street 1:5874 CRYSTAL SHORES DR
Practice Address - Street 2:#208
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-5683
Practice Address - Country:US
Practice Address - Phone:954-465-2034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist