Provider Demographics
NPI:1790498640
Name:MASSILLON, ERLINE FRANCOIS (OTD)
Entity Type:Individual
Prefix:
First Name:ERLINE
Middle Name:FRANCOIS
Last Name:MASSILLON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6751 MERITMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-2294
Mailing Address - Country:US
Mailing Address - Phone:407-432-0308
Mailing Address - Fax:
Practice Address - Street 1:6751 MERITMOOR CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-2294
Practice Address - Country:US
Practice Address - Phone:407-432-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT-23779225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics