Laurin Derrick

Individual provider Active NPI Occupational Therapist · Heathrow, FL

NPI 1306016597 · NPPES record last updated Mar 4, 2008

Key facts

NPI
1306016597
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
4044 (AZ)
Practice address
1485 International Parkway
Suite #2051
Heathrow, FL 32746
Phone
(800) 798-6035
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4044AZMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Voyage Staffing Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4044 AZ Yes

Addresses

Primary practice location

1485 International Parkway
Suite #2051
Heathrow, FL 32746

Mailing address

1485 International Parkway
Suite #2051
Heathrow, FL 32746
Phone (800) 798-6035

Other identifiers

IdentifierTypeStateIssuer
4044OtherAZAZ LICENSE #

Other providers in Heathrow, FL

All providers in Heathrow, FL · Occupational Therapist in Florida

Sources for this page

Verify at the official NPI Registry.