Healthcare Provider Details

I. General information

NPI: 1962042929
Provider Name (Legal Business Name): ANGELICA MARIA FABBRI OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 W FLETCHER AVE STE 104
TAMPA FL
33612-3366
US

IV. Provider business mailing address

1344 W FLETCHER AVE STE 104
TAMPA FL
33612-3366
US

V. Phone/Fax

Practice location:
  • Phone: 813-961-1666
  • Fax:
Mailing address:
  • Phone: 813-961-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: