Healthcare Provider Details

I. General information

NPI: 1255469854
Provider Name (Legal Business Name): MARGOT ALICE BAKER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8254 118TH AV. NORTH SUITE 100
LARGO FL
33773-5027
US

IV. Provider business mailing address

4448 ZENITH RD.
VENICE FL
34293-6154
US

V. Phone/Fax

Practice location:
  • Phone: 727-541-5304
  • Fax: 727-546-8527
Mailing address:
  • Phone: 941-468-8818
  • Fax: 941-497-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT377
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT377
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: