Provider Demographics
NPI:1942334859
Name:OREN, TAMMY-ANNE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY-ANNE
Middle Name:
Last Name:OREN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14302 GOLDEN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32735-9126
Mailing Address - Country:US
Mailing Address - Phone:352-217-5673
Mailing Address - Fax:352-357-5428
Practice Address - Street 1:2808 RULEME ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6527
Practice Address - Country:US
Practice Address - Phone:352-357-5104
Practice Address - Fax:352-357-5104
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 9851224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant