Provider Demographics
NPI:1558864389
Name:MARQUARDT, AARYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:AARYN
Middle Name:
Last Name:MARQUARDT
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 1:5101 BRITTANY DR S
Mailing Address - Street 2:STE 16
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1565
Mailing Address - Country:US
Mailing Address - Phone:727-308-9848
Mailing Address - Fax:
Practice Address - Street 1:15325 MONTESINO DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-6734
Practice Address - Country:US
Practice Address - Phone:407-760-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17554225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist