Provider Demographics
NPI:1437230042
Name:MUELLER, GERALDINE (MA,OT)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MA,OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 VILLAGE PARK RD
Mailing Address - Street 2:103
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-2079
Mailing Address - Country:US
Mailing Address - Phone:813-704-4488
Mailing Address - Fax:
Practice Address - Street 1:602 VONDENBURG DRIVE SUITE 201
Practice Address - Street 2:BETH INGRAM AND ASSOCIATES
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-653-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101071225X00000X
FLOT 12922225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist