MEDICARE: LEA BERTONI

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	OTH-006162	AZ

General Provider Information

NPI Number	:	1144574534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA BERTONI

Provider Business Mailing Address
First Line	:	1414 W BROADWAY RD STE 111
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-1121
Country	:	US
Telephone Number	:	480-449-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1414 W BROADWAY RD STE 111
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-1121
Country	:	US
Telephone Number	:	480-449-3331
Fax Number	:

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

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	02/05/2026

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Directions to “ LEA BERTONI ” Practice Location

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