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General NPI Number Information
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NPI Number | 1558237701
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Entity Type | Individual
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Provider Name | MR. DARRYL BENTLY OTT
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Gender | Male
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 10300 49TH ST N STE 124
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City | CLEARWATER
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State | FL
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Zip | 33762-5000
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Country | US
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Telephone | 727-788-4226
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Fax | 727-788-4226
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Provider Business Mailing Address
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Address Line | 921 10TH ST SW STE 124
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City | LARGO
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State | FL
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Zip | 33770-4428
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Country | US
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Telephone | 727-788-4226
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Fax | 727-308-6779
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299996159
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License Number State | FL
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