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General NPI Number Information
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NPI Number | 1770968174
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Entity Type | Organization
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Legal Business Name | TRUE BLUE PEDS THERAPY
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 1097 E. BRANDON BLVD
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-486-1718
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Fax | 813-643-4591
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Provider Business Mailing Address
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Address Line | 1810 FLAT BRANCH CT.,
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City | VALRICO
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State | FL
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Zip | 33594
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Country | US
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Telephone | 813-486-1718
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Fax | 813-643-4591
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Authorized Official
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Title or Position | OTR/L MGR OCC. THERAPIST
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Name | MRS. DHARINI ZAVERI
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Credential | OTR/L
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Telephone | 813-643-4591
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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 |
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License Number State |
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