Tyler Scott Lacertosa, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

18954 Issued in FL

Practice address

201 N Clyde Morris Blvd Ste 300
Daytona Beach, FL 32114-2765

Phone

(386) 236-7017

NPI assigned

Feb 14, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sobe Innovative Rehabilitation PLLC

  • Physical Therapist
  • Miami, FL
  • NPI 1164800595

  Occupational Therapist

  NPD
• Strength and Balance Institute

  • Physical Therapist
  • Aventura, FL
  • NPI 1164077947

  Occupational Therapist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1003316274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-345-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 300",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-236-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACERTOSA",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "18954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Sue Kyer, LCSW
• Victoria Kyles
• L & L Beach Street, LLC
• L & L DB, LLC
• Krista Jade Labelle, MD
• Kathleen Lachcik
• Alfea Lacierda, MD
• Ayodeji Ladele, D.O.
• Randy Briane Valencia Lagmay, PA-C
• Lakeside Endocrine Associates, Inc

• Occupational Therapist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.