Provider Demographics
NPI:1245540616
Name:IRIZARRY, BETSY NOELLE BOYCE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:NOELLE BOYCE
Last Name:IRIZARRY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:N
Other - Last Name:BOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6611 CLAIR SHORE DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3305
Mailing Address - Country:US
Mailing Address - Phone:813-334-1596
Mailing Address - Fax:
Practice Address - Street 1:10917 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4112
Practice Address - Country:US
Practice Address - Phone:813-962-6766
Practice Address - Fax:813-962-3017
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200424225X00000X
FLOT 15788225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist