Provider Demographics
NPI:1659587483
Name:URBINA, DONNA LORI (OTRL)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LORI
Last Name:URBINA
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5739
Mailing Address - Country:US
Mailing Address - Phone:407-788-1614
Mailing Address - Fax:
Practice Address - Street 1:142 W LAKEVIEW AVE
Practice Address - Street 2:SUITE 2010
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2903
Practice Address - Country:US
Practice Address - Phone:407-323-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9532225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics