Provider Demographics
NPI:1043652670
Name:MAY, STEPHANIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 TRINITY LN N
Mailing Address - Street 2:APT 8103
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1278
Mailing Address - Country:US
Mailing Address - Phone:570-906-5341
Mailing Address - Fax:
Practice Address - Street 1:2130 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2323
Practice Address - Country:US
Practice Address - Phone:727-587-0582
Practice Address - Fax:727-587-0583
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8769225X00000X
GA005496225X00000X
FLOT17080225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015012200Medicaid