Provider Demographics
NPI:1790008308
Name:HOWELL, ROSALEE (OTR)
Entity Type:Individual
Prefix:
First Name:ROSALEE
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4423
Mailing Address - Country:US
Mailing Address - Phone:407-539-2488
Mailing Address - Fax:407-539-2408
Practice Address - Street 1:630 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4423
Practice Address - Country:US
Practice Address - Phone:407-539-2488
Practice Address - Fax:407-539-2408
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888847700Medicaid