Provider Demographics
NPI:1346784931
Name:SARAGUSA, RACHEL LYNNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LYNNE
Last Name:SARAGUSA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 63RD AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-5730
Mailing Address - Country:US
Mailing Address - Phone:318-471-3403
Mailing Address - Fax:
Practice Address - Street 1:4927 VOORHEES RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-5542
Practice Address - Country:US
Practice Address - Phone:727-848-3578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17985225X00000X
LA302221225X00000X
TX117831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist