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General NPI Number Information
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NPI Number | 1902037757
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Entity Type | Individual
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Provider Name | MEGHAN LEIGH O'BRIEN LMT
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Gender | Female
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 07/28/2009
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Provider Practice Location Address
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Address Line | 2831 RINGLING BLVD SUITE 104-A
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City | SARASOTA
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State | FL
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Zip | 34237-5334
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Country | US
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Telephone | 941-915-2681
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Fax |
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Provider Business Mailing Address
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Address Line | 2831 RINGLING BLVD SUITE 104-A
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City | SARASOTA
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State | FL
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Zip | 34237-5334
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Country | US
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Telephone | 941-915-2681
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA 46539
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License Number State | FL
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