Provider Demographics
NPI:1356435382
Name:LLULL, ANTONIA (MOT,OTR/L)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:LLULL
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 MAITLAND AVE STE 1150
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6306
Mailing Address - Country:US
Mailing Address - Phone:321-972-1617
Mailing Address - Fax:321-972-1947
Practice Address - Street 1:505 MAITLAND AVE STE 1150
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6306
Practice Address - Country:US
Practice Address - Phone:321-972-1617
Practice Address - Fax:321-972-1947
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8396225X00000X
NY019956-1225X00000X
NJ46TR00716600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884360100Medicaid
FL125827900Medicaid