Provider Demographics
NPI:1952773848
Name:VICTORINE, ARNE
Entity Type:Individual
Prefix:
First Name:ARNE
Middle Name:
Last Name:VICTORINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35246 US HIGHWAY 19 N # 161
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1931
Mailing Address - Country:US
Mailing Address - Phone:727-501-5832
Mailing Address - Fax:
Practice Address - Street 1:35246 US HIGHWAY 19 N # 161
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1931
Practice Address - Country:US
Practice Address - Phone:727-501-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9692225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist