NPI Code Details Logo

NPI 1669013488

NPI 1669013488 : BRIDGETT CORIN POWE OT : RIVERVIEW, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1669013488
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    BRIDGETT CORIN POWE OT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/02/2019
-----------------------------------------------------
    Last Update Date     |    12/07/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11286 BOYETTE RD STE 101 
-----------------------------------------------------
    City                 |    RIVERVIEW
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33569-8022
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    813-978-9700
-----------------------------------------------------
    Fax                  |    813-558-6185
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    13020 N TELECOM PKWY 
-----------------------------------------------------
    City                 |    TEMPLE TERRACE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33637-0925
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    813-978-9700
-----------------------------------------------------
    Fax                  |    813-558-6185
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    OT20140
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.