Active NPI
Lisa M Robertson, OT
- Occupational Therapist
- Gulf Breeze, FL
National Provider Identifier
1356595664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 3379
- Practice address
- 3408 Santa Rosa Dr
Gulf Breeze, FL 32563-5665 - Phone
- (850) 932-4078
- Fax
- (850) 932-8918
- NPI assigned
- Nov 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 3379 | FL | Primary |
Addresses
Primary practice location
3408 Santa Rosa Dr
Gulf Breeze, FL 32563-5665
Mailing address
3408 Santa Rosa Dr
Gulf Breeze, FL 32563-5665
Phone (850) 932-4078
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT 3379 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372291200000",
"number": "1356595664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3408 SANTA ROSA DR",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325635665",
"telephone_number": "850-932-4078",
"fax_number": "850-932-8918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3408 SANTA ROSA DR",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325635665",
"telephone_number": "850-932-4078",
"fax_number": "850-932-8918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "LISA",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-13",
"last_updated": "2013-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT 3379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.