Provider Demographics
NPI:1851440259
Name:FABO, MARLENE S (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:S
Last Name:FABO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:MARLENE
Other - Middle Name:S
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6342 BRADFORD HILL CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4871
Mailing Address - Country:US
Mailing Address - Phone:813-731-1018
Mailing Address - Fax:
Practice Address - Street 1:6342 BRADFORD HILL CT
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4871
Practice Address - Country:US
Practice Address - Phone:813-731-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9690225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27613OtherBCBS
FL11940001OtherCITRUS HMO
FL886199400Medicaid
FL354934OtherWELLCARE