Healthcare Provider Details

I. General information

NPI: 1164546909
Provider Name (Legal Business Name): LYNN ANN AGNEW OTRL CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN ANN TRITSCHELLER OTRL

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 02/11/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 WEST WATERS AVENUE
TAMPA FL
33614
US

IV. Provider business mailing address

16531 LAKE HEATHER DR
TAMPA FL
33618-1168
US

V. Phone/Fax

Practice location:
  • Phone: 813-932-5119
  • Fax:
Mailing address:
  • Phone: 727-643-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number6157
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT6157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: