Provider Demographics
NPI:1962796813
Name:GOTTLIEB, CARAN (OTR/L)
Entity type:Individual
Prefix:
First Name:CARAN
Middle Name:
Last Name:GOTTLIEB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11902 NW 53RD CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3226
Mailing Address - Country:US
Mailing Address - Phone:954-649-7123
Mailing Address - Fax:
Practice Address - Street 1:11902 NW 53RD CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3226
Practice Address - Country:US
Practice Address - Phone:954-649-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7822225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics