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NPI Code Detail

MEDICARE: NICOLE DAHLENBURG OTR/L

MEDICARE: NICOLE DAHLENBURG OTR/L
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
1225X00000XOccupational TherapistOT26042FL
2225XP0200XPediatric Occupational Therapist24745CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
124745OTHERCAOCCUPATIONAL THERAPIST
2OT26042OTHERFLOCCUPATIONAL THERAPIST REGISTERED AND LICENSED

General Provider Information

NPI Number : 1518664523
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE DAHLENBURG OTR/L
Provider Business Mailing Address
First Line : 1600 CENTER RD
Second Line :
City : VENICE
State : FL
Zip : 34292-3841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 CENTER RD
Second Line :
City : VENICE
State : FL
Zip : 34292-3841
Country : US
Telephone Number : 678-294-9173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2023
Last Update Date : 04/10/2026

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Directions to “ NICOLE DAHLENBURG OTR/L” Practice Location

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