Provider Demographics
NPI:1053512020
Name:FONTANET ESCRIBANO, ANABELLE (OT)
Entity Type:Individual
Prefix:MRS
First Name:ANABELLE
Middle Name:
Last Name:FONTANET ESCRIBANO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 IMPERIAL EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1273
Mailing Address - Country:US
Mailing Address - Phone:407-421-9579
Mailing Address - Fax:
Practice Address - Street 1:4717 IMPERIAL EAGLE DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1273
Practice Address - Country:US
Practice Address - Phone:407-421-9579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4465225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1053512020Medicaid