Provider Demographics
NPI:1952877565
Name:LEVENTHAL, ANTONELLA (OT)
Entity Type:Individual
Prefix:
First Name:ANTONELLA
Middle Name:
Last Name:LEVENTHAL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CAYMAN PL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8095
Mailing Address - Country:US
Mailing Address - Phone:561-201-2872
Mailing Address - Fax:
Practice Address - Street 1:48 CAYMAN PL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8095
Practice Address - Country:US
Practice Address - Phone:561-201-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9917225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty