Provider Demographics
NPI:1760545941
Name:ROSSI, TRACEY LYNN (OTR-L)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:LYNN
Last Name:ROSSI
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 1:10811 OAK BEND WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6175
Mailing Address - Country:US
Mailing Address - Phone:561-685-1001
Mailing Address - Fax:561-753-4572
Practice Address - Street 1:5055 S CONGRESS AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4722
Practice Address - Country:US
Practice Address - Phone:561-966-3380
Practice Address - Fax:561-966-7599
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8069225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist