Provider Demographics
NPI:1134779846
Name:MOHAMED, LENA (OTR/L)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:MOHAMED
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 1:14128 SANCTUARY TERRACE LN UNIT 307
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6648
Mailing Address - Country:US
Mailing Address - Phone:716-228-2967
Mailing Address - Fax:
Practice Address - Street 1:14055 TOWN LOOP BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6106
Practice Address - Country:US
Practice Address - Phone:407-857-6285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20351225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist