Provider Demographics
NPI:1073893194
Name:RAJASEKHAR, K V (OT)
Entity Type:Individual
Prefix:MR
First Name:K V
Middle Name:
Last Name:RAJASEKHAR
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4313 W NORTH A ST APT 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2135
Mailing Address - Country:US
Mailing Address - Phone:813-766-9135
Mailing Address - Fax:
Practice Address - Street 1:4313 W NORTH A ST APT 2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2135
Practice Address - Country:US
Practice Address - Phone:813-766-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2714225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist