Provider Demographics
NPI:1942289012
Name:LAMAR, HEIDI L (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:L
Last Name:LAMAR
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 1:1450 YAKUTAT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-4178
Mailing Address - Country:US
Mailing Address - Phone:941-441-7217
Mailing Address - Fax:
Practice Address - Street 1:3938 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3622
Practice Address - Country:US
Practice Address - Phone:941-366-0011
Practice Address - Fax:941-957-0033
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 6316225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z098GOtherBLUE CROSS BLUE SHIELD FL
Z098GOtherBLUE CROSS BLUE SHIELD FL