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General NPI Number Information
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NPI Number | 1730239823
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Entity Type | Individual
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Provider Name | HEATHER LEIGH DITARANTO OTRL
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 11009 THERESA ARBOR DR
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-3166
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Country | US
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Telephone | 813-841-7484
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Fax | 813-570-6693
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Provider Business Mailing Address
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Address Line | 17818 MISSION OAK DR
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City | LITHIA
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State | FL
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Zip | 33547-4803
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Country | US
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Telephone | 813-841-7484
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Fax | 813-571-5511
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT9497
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License Number State | FL
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