Healthcare Provider Details

I. General information

NPI: 1538400049
Provider Name (Legal Business Name): HEATHER LYNN BOROWSKI MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER LYNN HUMPHREY

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 S PARSONS AVE
BRANDON FL
33511-6063
US

IV. Provider business mailing address

3817 SOUTHVIEW DR
BRANDON FL
33511-7827
US

V. Phone/Fax

Practice location:
  • Phone: 850-240-0831
  • Fax:
Mailing address:
  • Phone: 850-240-0831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT15618
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number15618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: