Provider Demographics
NPI:1518510015
Name:MILLER, LYNN S (OTR/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13568 NW 1ST LN STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3698
Mailing Address - Country:US
Mailing Address - Phone:352-331-9448
Mailing Address - Fax:352-331-9621
Practice Address - Street 1:13568 NW 1ST LN STE 1
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3698
Practice Address - Country:US
Practice Address - Phone:352-331-9448
Practice Address - Fax:352-331-9621
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12722225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist