Provider Demographics
NPI:1578991220
Name:VLASS, KAYE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:
Last Name:VLASS
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 1:632 LIMONA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4121
Mailing Address - Country:US
Mailing Address - Phone:813-625-6150
Mailing Address - Fax:
Practice Address - Street 1:724 BOWING OAK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5974
Practice Address - Country:US
Practice Address - Phone:813-625-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18263225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist