Provider Demographics
NPI:1477218758
Name:KEYSER, BLAKELY PAIGE (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:BLAKELY
Middle Name:PAIGE
Last Name:KEYSER
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16784 HAMLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1736
Mailing Address - Country:US
Mailing Address - Phone:561-779-8307
Mailing Address - Fax:
Practice Address - Street 1:17781 THELMA AVE
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7942
Practice Address - Country:US
Practice Address - Phone:561-746-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT22129225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist