Healthcare Provider Details

I. General information

NPI: 1811808603
Provider Name (Legal Business Name): PLAY. EAT. THRIVE. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 JULIE LN
BRANDON FL
33511-6403
US

IV. Provider business mailing address

115 JULIE LN
BRANDON FL
33511-6403
US

V. Phone/Fax

Practice location:
  • Phone: 813-892-0801
  • Fax:
Mailing address:
  • Phone: 813-892-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANNA COLLEEN BLAZINA
Title or Position: OWNER, OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 813-892-0801