Individual provider Active NPI

Odette Ghanem, OT

  • Occupational Therapist
  • Miami, FL
National Provider Identifier
1023441896
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT15819 Issued in FL
Practice address
9700 SW 136TH St
Miami, FL 33176-6760
Phone
(305) 244-5062
NPI assigned
Aug 16, 2013
Last updated
Aug 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT15819 FL Primary

Addresses

Primary practice location

9700 SW 136TH St
Miami, FL 33176-6760

Mailing address

9700 SW 136TH St
Miami, FL 33176-6760
Phone (305) 244-5062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210000368 FL Practitioner - Occupational Therapist in Private Practice 7810124286 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT15819FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolanos Associates, LLC. Occupational Therapist CurrentSince Aug 14, 2025 Accepting new patients
Therapy Solution Group LLC CurrentSince Apr 13, 2018 Accepting new patients

Locations

4801 S University Dr
Ste 101
Davie, FL 33328
Phone (786) 259-0300

13335 SW 124th St
Ste 202
Miami, FL 33186
Phone (786) 259-0300

1150 NW 72nd Ave
Ste 720
Miami, FL 33126
Phone (305) 599-1990

15751 Sheridan St
Southwest Ranches, FL 33331
Phone (305) 819-9300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1023441896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 SW 136TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331766760",
            "telephone_number": "305-244-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 SW 136TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331766760",
            "telephone_number": "305-244-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "ODETTE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.