Provider Demographics
NPI:1972732915
Name:DAVID, DIANN RITA (OTR)
Entity Type:Individual
Prefix:
First Name:DIANN
Middle Name:RITA
Last Name:DAVID
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 1:600 NORTH BLVD W
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5063
Mailing Address - Country:US
Mailing Address - Phone:352-728-6636
Mailing Address - Fax:352-787-4522
Practice Address - Street 1:1400 N US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8975
Practice Address - Country:US
Practice Address - Phone:352-753-6999
Practice Address - Fax:352-259-0002
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist