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General NPI Number Information
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NPI Number | 1730384785
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Entity Type | Individual
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Provider Name | KAREN SPISAK OTR
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4440B 26TH ST W
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City | BRADENTON
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State | FL
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Zip | 34207-1201
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Country | US
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Telephone | 941-752-0408
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Fax | 941-870-0876
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Provider Business Mailing Address
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Address Line | 3007 48TH AVENUE DR E
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City | BRADENTON
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State | FL
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Zip | 34203-3929
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Country | US
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Telephone | 941-752-0408
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Fax | 941-870-0876
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT4661
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License Number State | FL
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