Individual provider Active NPI

Vanessa Lynn Landeau, COTA/L

  • Occupational Therapy Assistant
  • Palm Harbor, FL
National Provider Identifier
1134493794
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA12068 Issued in FL
Practice address
34921 US Highway 19 N
Ste 450
Palm Harbor, FL 34684-1969
Phone
(727) 573-2747
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA12068 FL Primary

Addresses

Primary practice location

34921 US Highway 19 N
Ste 450
Palm Harbor, FL 34684-1969

Mailing address

560 Tiberon Cove Rd
Longwood, FL 32750-2951
Phone (407) 617-6802

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA12068FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1134493794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 TIBERON COVE RD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327502951",
            "telephone_number": "407-617-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34921 US HIGHWAY 19 N",
            "address_2": "STE 450",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841969",
            "telephone_number": "727-573-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDEAU",
        "first_name": "VANESSA",
        "middle_name": "LYNN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA12068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.