Provider Demographics
NPI:1053095737
Name:PICHARDO, ABIGAIL FAITH (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:FAITH
Last Name:PICHARDO
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:FAITH
Other - Last Name:BIZUB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9200 NW 39TH AVE STE 130-3364
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7331
Mailing Address - Country:US
Mailing Address - Phone:352-474-0543
Mailing Address - Fax:
Practice Address - Street 1:9200 NW 39TH AVE STE 130-3364
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7331
Practice Address - Country:US
Practice Address - Phone:352-474-0543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT21520225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist