Provider Demographics
NPI:1053067280
Name:SWARTZ, ALEXIS (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 N LOIS AVE APT 1326
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2558
Mailing Address - Country:US
Mailing Address - Phone:954-647-6719
Mailing Address - Fax:
Practice Address - Street 1:2370 BRUCE B DOWNS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9215
Practice Address - Country:US
Practice Address - Phone:813-973-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist