Provider Demographics
NPI:1447562822
Name:MAHARANA, TIMATHIE DEVI (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TIMATHIE
Middle Name:DEVI
Last Name:MAHARANA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 AVENTURA BLVD UNIT 1-204
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8231
Mailing Address - Country:US
Mailing Address - Phone:646-623-1200
Mailing Address - Fax:
Practice Address - Street 1:2606 AVENTURA BLVD UNIT 1-204
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8231
Practice Address - Country:US
Practice Address - Phone:646-623-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20055225X00000X
NY007617225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics