Provider Demographics
NPI:1699971994
Name:HARTMAN, ELIZABETH (OT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7233
Mailing Address - Country:US
Mailing Address - Phone:954-946-6412
Mailing Address - Fax:
Practice Address - Street 1:315 CADIMA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7307
Practice Address - Country:US
Practice Address - Phone:305-219-9030
Practice Address - Fax:305-437-8045
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11844225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist