Healthcare Provider Details

I. General information

NPI: 1073604492
Provider Name (Legal Business Name): ROBIN LEIGH HURLEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BAY PINES BLVD
BAY PINES FL
33744
US

IV. Provider business mailing address

4027 25TH AVE N
ST PETERSBURG FL
33713-3318
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax:
Mailing address:
  • Phone: 727-327-9022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 5311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: