Provider Demographics
NPI:1396397923
Name:CAIRNS, SETH (OTA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:CAIRNS
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 NE 14TH WAY APT 6
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4985
Mailing Address - Country:US
Mailing Address - Phone:859-351-6047
Mailing Address - Fax:
Practice Address - Street 1:5220 NE 14TH WAY APT 6
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-4985
Practice Address - Country:US
Practice Address - Phone:859-351-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-13
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA13682224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant