Healthcare Provider Details

I. General information

NPI: 1437222387
Provider Name (Legal Business Name): SAVITRIE T ABDUL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 AVE. B, SE
WINTER HAVEN FL
33880
US

IV. Provider business mailing address

150 AVE. B, SE
WINTER HAVEN FL
33880
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-1429
  • Fax: 863-298-0299
Mailing address:
  • Phone: 863-294-1429
  • Fax: 863-298-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number013678
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT12600
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: