Active NPI
Brooke Michele Wilder, MSOT
- Occupational Therapist
- Miami, FL
National Provider Identifier
1366223596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT24665
- Practice address
- 592 NE 60TH St
Miami, FL 33137-2246 - Phone
- (305) 757-1966
- NPI assigned
- Oct 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT24665 | FL | Primary |
Addresses
Primary practice location
592 NE 60TH St
Miami, FL 33137-2246
Mailing address
4294 SW 131St Ave
Davie, FL 33330-4732
Phone (954) 551-3702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT24665 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1366223596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4294 SW 131ST AVE",
"city": "DAVIE",
"state": "FL",
"postal_code": "333304732",
"telephone_number": "954-551-3702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "592 NE 60TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331372246",
"telephone_number": "305-757-1966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "BROOKE",
"middle_name": "MICHELE",
"credential": "MSOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-12",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT24665",
"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 Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.