Provider Demographics
NPI:1386445823
Name:SKODY, ANTHONY THOMAS (OTA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:THOMAS
Last Name:SKODY
Suffix:
Gender:
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5171 NE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1601
Mailing Address - Country:US
Mailing Address - Phone:954-298-5544
Mailing Address - Fax:
Practice Address - Street 1:5171 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-1601
Practice Address - Country:US
Practice Address - Phone:954-298-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12401224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant