Provider Demographics
NPI:1184701542
Name:OT REHAB SOLUTIONS LLC
Entity type:Organization
Organization Name:OT REHAB SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:CATE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:813-541-8760
Mailing Address - Street 1:15035 EAGLERISE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3803
Mailing Address - Country:US
Mailing Address - Phone:813-541-8760
Mailing Address - Fax:866-492-7804
Practice Address - Street 1:15035 EAGLERISE DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3803
Practice Address - Country:US
Practice Address - Phone:813-541-8760
Practice Address - Fax:866-492-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5529AOtherMEDICARE PTAN