Provider Demographics
NPI:1467406793
Name:HARVEY, SARAH (OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HARVEY
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 1:14841 SKIP JACK LOOP
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5878
Mailing Address - Country:US
Mailing Address - Phone:941-962-3046
Mailing Address - Fax:
Practice Address - Street 1:1962 VANDOLAH RD
Practice Address - Street 2:
Practice Address - City:WAUCHULA
Practice Address - State:FL
Practice Address - Zip Code:33873-8726
Practice Address - Country:US
Practice Address - Phone:863-767-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ098MOtherBCBS FL
FLU6152AMedicare ID - Type Unspecified