Provider Demographics
NPI:1417903741
Name:OSPINA, OLGA L (OT)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:L
Last Name:OSPINA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12550 WESTHAMPTON CIR APT 1501
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5581
Mailing Address - Country:US
Mailing Address - Phone:561-430-8070
Mailing Address - Fax:
Practice Address - Street 1:12550 WESTHAMPTON CIR APT 1501
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5581
Practice Address - Country:US
Practice Address - Phone:561-430-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889424800Medicaid