Provider Demographics
NPI:1235358516
Name:HOBSON, CAROL S (OTR)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:S
Last Name:HOBSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:S
Other - Last Name:BORBELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1197 COUNTY ROAD 309
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32112-4813
Mailing Address - Country:US
Mailing Address - Phone:386-467-8732
Mailing Address - Fax:
Practice Address - Street 1:1197 COUNTY ROAD 309
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:FL
Practice Address - Zip Code:32112-4813
Practice Address - Country:US
Practice Address - Phone:386-467-8732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2296174400000X
FLOT2296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT2296Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPIST