Healthcare Provider Details

I. General information

NPI: 1538430756
Provider Name (Legal Business Name): LARA PITWOOD OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 PARK OF COMMERCE BLVD CROSS COUNTRY TRAVCORPS
BOCA RATON FL
33487-8218
US

IV. Provider business mailing address

6551 PARK OF COMMERCE BLVD CROSS COUNTRY TRAVCORPS
BOCA RATON FL
33487-8218
US

V. Phone/Fax

Practice location:
  • Phone: 800-347-2264
  • Fax: 561-998-8533
Mailing address:
  • Phone: 800-347-2264
  • Fax: 561-998-8533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number12432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: