Provider Demographics
NPI:1306550009
Name:ACHEAMPONG, GIFTY
Entity type:Individual
Prefix:
First Name:GIFTY
Middle Name:
Last Name:ACHEAMPONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 VIA MURANO CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5499
Mailing Address - Country:US
Mailing Address - Phone:813-817-4038
Mailing Address - Fax:
Practice Address - Street 1:9461 HEALTHPARK CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3614
Practice Address - Country:US
Practice Address - Phone:239-365-1769
Practice Address - Fax:239-603-0459
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT22595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist