MEDICARE: FLORALDINE TIMOTHEE OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	124288	TX

General Provider Information

NPI Number	:	1053901637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORALDINE TIMOTHEE OTR

Provider Business Mailing Address
First Line	:	8101 BOAT CLUB RD STE 330
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-3633
Country	:	US
Telephone Number	:	682-498-3928
Fax Number	:	214-935-2457

Provider Business Practice Location Address
First Line	:	201 BILLINGS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-5401
Country	:	US
Telephone Number	:	682-800-4620
Fax Number	:	214-935-2457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/30/2024

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Directions to “ FLORALDINE TIMOTHEE OTR” Practice Location

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