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NPI Code Detail

MEDICARE: LISA CASALE LIEB OTR/L

MEDICARE:   LISA CASALE LIEB  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist19358FL

General Provider Information

NPI Number : 1851868590
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA CASALE LIEB OTR/L
Provider Business Mailing Address
First Line : 5515 1ST AVE E APT 307
Second Line :
City : BRADENTON
State : FL
Zip : 34208-6142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1902 59TH ST W
Second Line :
City : BRADENTON
State : FL
Zip : 34209-4602
Country : US
Telephone Number : 941-761-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2018
Last Update Date : 10/31/2018

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Directions to “ LISA CASALE LIEB OTR/L” Practice Location

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