MEDICARE: MS. SUZETTE LYNN LA RUSSA 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
1	225X00000X	Occupational Therapist	OT8465	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841391711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZETTE LYNN LA RUSSA OTR/L

Provider Business Mailing Address
First Line	:	22020 HEATHERWOOD LN
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4566
Country	:	US
Telephone Number	:	813-690-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	22020 HEATHERWOOD LN
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4566
Country	:	US
Telephone Number	:	813-690-6000
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	02/20/2026

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