Provider Demographics
NPI:1942308416
Name:PARKER, JUDITH W (OTR)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:W
Last Name:PARKER
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 1:5899 WHITFIELD AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6152
Mailing Address - Country:US
Mailing Address - Phone:941-359-2977
Mailing Address - Fax:941-359-2966
Practice Address - Street 1:255 COURTYARD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5794
Practice Address - Country:US
Practice Address - Phone:813-633-2887
Practice Address - Fax:813-634-8671
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10067225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ075EYMedicare ID - Type UnspecifiedMCB