Provider Demographics
NPI:1053830794
Name:KRAUTHEIM, DEBORAH SUZAN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUZAN
Last Name:KRAUTHEIM
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:SUZY
Other - Middle Name:
Other - Last Name:KRAUTHEIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3128 SUNWATCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:WESLY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544
Mailing Address - Country:US
Mailing Address - Phone:813-416-6017
Mailing Address - Fax:
Practice Address - Street 1:38250 A AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542
Practice Address - Country:US
Practice Address - Phone:813-416-6017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA8019224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant