Provider Demographics
NPI:1407959323
Name:AUSTIN, DEBORAH J (OTR CHT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:OTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 NW 2ND AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6652
Mailing Address - Country:US
Mailing Address - Phone:561-362-8757
Mailing Address - Fax:561-362-8949
Practice Address - Street 1:2061 NW 2ND AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6652
Practice Address - Country:US
Practice Address - Phone:561-362-8757
Practice Address - Fax:561-362-8949
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1444225X00000X, 225XH1200X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650151562OtherTAX ID NO
FLOT1444OtherOCCUPATIONAL THERAPY
FL650151562OtherTAX ID NO
FLZ3088Medicare PIN