Provider Demographics
NPI:1518285188
Name:BAPTISTE, SAMUEL JR (OTR)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:
Last Name:BAPTISTE
Suffix:JR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9328 MANDRAKE CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3289
Mailing Address - Country:US
Mailing Address - Phone:336-926-0133
Mailing Address - Fax:
Practice Address - Street 1:9328 MANDRAKE CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3289
Practice Address - Country:US
Practice Address - Phone:336-926-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA213905225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist