Provider Demographics
NPI:1437384450
Name:OBER, LIESELOT (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LIESELOT
Middle Name:
Last Name:OBER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 N ROCKY POINT DR
Mailing Address - Street 2:SUITE 650
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5917
Mailing Address - Country:US
Mailing Address - Phone:800-892-0640
Mailing Address - Fax:
Practice Address - Street 1:2701 N ROCKY POINT DR
Practice Address - Street 2:SUITE 650
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5917
Practice Address - Country:US
Practice Address - Phone:800-892-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12014225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist