Lidu Ivette Potter – Pediatric Occupational Therapist

Key facts

NPI: 1013024686
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Occupational Therapist 225XP0200X
License: OT10194 (FL)
Practice address: 971 Virginia Ave
Suite a
Palm Harbor, FL 34683-5235
Phone: (727) 773-2687
Fax: (727) 773-2742
NPI assigned: Aug 23, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

About All Kids Therapy Services LLC Speech-Language Pathologist · Lutz, FL · NPI 1770130643

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
OT10194	FL	MD	Pediatric Occupational Therapist

Practice roles

Organization	Specialty	Status	New patients
About All Kids Therapy Services LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Occupational Therapist	225XP0200X	OT10194	FL	Yes

Addresses

Primary practice location

971 Virginia Ave
Suite a
Palm Harbor, FL 34683-5235

Mailing address

2150 Alt 19 Ste a
Palm, FL 34683-5363
Phone (727) 773-2687

Other identifiers

Identifier	Type	State	Issuer
887471900	Medicaid	FL

Other providers in Palm Harbor, FL

All providers in Palm Harbor, FL · Pediatric Occupational Therapist in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.