Provider Demographics
NPI:1831249937
Name:ZDRUBECKY, CARRIE (OTR)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:ZDRUBECKY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 LEONA DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-4341
Mailing Address - Country:US
Mailing Address - Phone:727-581-2342
Mailing Address - Fax:
Practice Address - Street 1:1320 LEONA DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-4341
Practice Address - Country:US
Practice Address - Phone:727-581-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5993225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist