Healthcare Provider Details

I. General information

NPI: 1407194442
Provider Name (Legal Business Name): LINDSEY H TELG MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4703 NW 53RD AVE STE A2
GAINESVILLE FL
32653-3403
US

IV. Provider business mailing address

4703 NW 53RD AVE STE A2
GAINESVILLE FL
32653-3403
US

V. Phone/Fax

Practice location:
  • Phone: 352-332-6131
  • Fax: 352-332-6263
Mailing address:
  • Phone: 352-332-6131
  • Fax: 352-505-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTT15574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: