Provider Demographics
NPI:1659410017
Name:O.T. CENTER INC.
Entity Type:Organization
Organization Name:O.T. CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORIO
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:910-454-9001
Mailing Address - Street 1:3605 W BEACH DR
Mailing Address - Street 2:
Mailing Address - City:OAK ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28465-7842
Mailing Address - Country:US
Mailing Address - Phone:910-454-9001
Mailing Address - Fax:910-454-4039
Practice Address - Street 1:5083 SOUTHPORT SUPPLY RD SE
Practice Address - Street 2:UNIT 4
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8155
Practice Address - Country:US
Practice Address - Phone:910-454-9001
Practice Address - Fax:910-454-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2929225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301535Medicaid
NC7211567Medicaid
NC133V5OtherBLUE CROSS BLUE SHIELD