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General NPI Number Information
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NPI Number | 1336088269
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Entity Type | Individual
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Provider Name | MR. DAVID OTTERSBACH
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Gender | Male
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 1309 SUNSET WIND LOOP
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City | OLDSMAR
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State | FL
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Zip | 34677-4822
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Country | US
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Telephone | 727-643-2301
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 SUNSET WIND LOOP
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City | OLDSMAR
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State | FL
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Zip | 34677-4822
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Country | US
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Telephone | 727-643-2301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN9273329
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License Number State | FL
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