Provider Demographics
NPI:1780954545
Name:PAGE, SARAH O (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:O
Last Name:PAGE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:O
Other - Last Name:GIBBONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5107 3RD AVENUE DR NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2654
Mailing Address - Country:US
Mailing Address - Phone:941-526-2722
Mailing Address - Fax:
Practice Address - Street 1:6305 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2604
Practice Address - Country:US
Practice Address - Phone:941-761-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist