Provider Demographics
NPI:1215155999
Name:DEVINE, GINGER M (OT)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:M
Last Name:DEVINE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:S
Other - Last Name:MONTESINOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:5801 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5918
Mailing Address - Country:US
Mailing Address - Phone:754-214-1510
Mailing Address - Fax:
Practice Address - Street 1:5801 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-5918
Practice Address - Country:US
Practice Address - Phone:754-214-1510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3118225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist