Provider Demographics
NPI:1982743423
Name:POSTEMA, MARCIA JEANNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:JEANNE
Last Name:POSTEMA
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 1:2212 GATEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-8853
Mailing Address - Country:US
Mailing Address - Phone:813-473-4180
Mailing Address - Fax:
Practice Address - Street 1:1215 E ORANGE ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5762
Practice Address - Country:US
Practice Address - Phone:863-802-3800
Practice Address - Fax:863-802-0480
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12581225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT 12581OtherFL PROF LICENSE
FLY905LOtherBCBS FL
FL15248601OtherCITRUS HEALTHCARE
FL892001000Medicaid