Provider Demographics
NPI:1801077300
Name:GRIFFIN, TIMOTHY PATRICK (OTR/L)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7947 CROSIER CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-1331
Mailing Address - Country:US
Mailing Address - Phone:727-848-5156
Mailing Address - Fax:727-848-5156
Practice Address - Street 1:7947 CROSIER CT
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-1331
Practice Address - Country:US
Practice Address - Phone:727-848-5156
Practice Address - Fax:727-848-5156
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10468225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist