Etikids, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

16418 Issued in FL

Legal business name

ETIKIDS, LLC

Practice address

1722 Magdalene Manor Dr
Tampa, FL 33613-1917

Phone

(813) 856-9449

Fax

(813) 962-6831

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Julie Blacker, MOT, OTR/L, MSED

Title

Occupational Therapist

Phone

(646) 544-4485

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1306248059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 MAGDALENE MANOR DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131917",
            "telephone_number": "813-856-9449",
            "fax_number": "813-962-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 MAGDALENE MANOR DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131917",
            "telephone_number": "813-856-9449",
            "fax_number": "813-962-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETIKIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "BLACKER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "646-544-4485",
        "authorized_official_credential": "MOT, OTR/L, MSED"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "16418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013898400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.