Provider Demographics
NPI:1750569281
Name:SMITH, DEBORAH L (OT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:LOPARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2045 MISTY SUNRISE TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9686
Mailing Address - Country:US
Mailing Address - Phone:941-376-1898
Mailing Address - Fax:941-343-9402
Practice Address - Street 1:5968 CLARK CENTER AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2715
Practice Address - Country:US
Practice Address - Phone:941-922-8200
Practice Address - Fax:941-343-9402
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT617225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885724500Medicaid