MEDICARE: LAURIE ANN CARLSON MOTR/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
1	225X00000X	Occupational Therapist	OT15421	FL

General Provider Information

NPI Number	:	1568328318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE ANN CARLSON MOTR/L

Provider Business Mailing Address
First Line	:	6203 S JONES RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-5027
Country	:	US
Telephone Number	:	402-658-1543
Fax Number	:	402-658-1543

Provider Business Practice Location Address
First Line	:	6203 S JONES RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-5027
Country	:	US
Telephone Number	:	402-658-1543
Fax Number	:

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

Provider Enumeration Date	:	12/24/2025
Last Update Date	:	12/24/2025

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Directions to “ LAURIE ANN CARLSON MOTR/L” Practice Location

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