Provider Demographics
NPI:1700306214
Name:PEDIATRIC THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OCCUPATIONAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANEY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:813-644-9596
Mailing Address - Street 1:15026 SOUTHFORK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2324
Mailing Address - Country:US
Mailing Address - Phone:813-719-0779
Mailing Address - Fax:
Practice Address - Street 1:15026 SOUTHFORK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2324
Practice Address - Country:US
Practice Address - Phone:813-719-0779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18317225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty