Provider Demographics
NPI:1497307391
Name:PAVLOVIC, BRITTANY RAE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:RAE
Last Name:PAVLOVIC
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 AVALON BLVD
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4601
Mailing Address - Country:US
Mailing Address - Phone:407-280-0338
Mailing Address - Fax:
Practice Address - Street 1:1024 WILLA SPRINGS DR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5214
Practice Address - Country:US
Practice Address - Phone:407-280-0338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12023224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant