Provider Demographics
NPI:1073744405
Name:TANKHIWALE, MEERA AJAY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MEERA
Middle Name:AJAY
Last Name:TANKHIWALE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:MEERA
Other - Middle Name:AJAY
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4448 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1216
Mailing Address - Country:US
Mailing Address - Phone:407-513-3000
Mailing Address - Fax:407-515-6519
Practice Address - Street 1:4448 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1216
Practice Address - Country:US
Practice Address - Phone:407-513-3000
Practice Address - Fax:407-515-6519
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3910225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist