Patricia Campbell Burks, OTR/L
Individual provider Active NPI Occupational Therapist · Lake Wales, FL
NPI 1235917519 · NPPES record last updated Sep 19, 2023
Key facts
- NPI
- 1235917519
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT23034 (FL)
- Practice address
- 10 W Grove Ave
Lake Wales, FL 33853-4516 - Phone
- (706) 415-6771
- NPI assigned
- Sep 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT23034 | FL | MD | Occupational Therapist |
| OT002566 | GA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT002566 | GA | |
| Occupational Therapist | 225X00000X | OT23034 | FL | Yes |
Addresses
Primary practice location
10 W Grove Ave
Lake Wales, FL 33853-4516
Mailing address
1537 Judy St
Lake Wales, FL 33898-6403
Phone (706) 415-6771
Other providers in Lake Wales, FL
- O'Shaine Brown
- Whitney Scott Brown
- Bailey Lyn Browning
- Robert E. Lee Browning IV
- Kyanna Marie Buisch
- Jeff Bush
- C&S Finest Care LLC
- Anthonette Signap Cabili
- Sydney Christine Cabrera
- Milcah Grace S Caculitan
All providers in Lake Wales, FL · 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 Sep 19, 2023. 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.