Provider Demographics
NPI:1912037607
Name:DOTTORELLI, MICHAEL (OT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DOTTORELLI
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 MERIDIAN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-9730
Mailing Address - Country:US
Mailing Address - Phone:850-219-1523
Mailing Address - Fax:850-201-3369
Practice Address - Street 1:3334 CAPITAL MEDICAL BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8405
Practice Address - Country:US
Practice Address - Phone:850-219-1923
Practice Address - Fax:850-201-3369
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist