Individual provider Active NPI

Deborah Anne Warrior, COTA/L

  • Occupational Therapy Assistant
  • Lakeland, FL
National Provider Identifier
1720391063
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA5783 Issued in FL
Practice address
411 E Orange St
Suite 204
Lakeland, FL 33801-5054
Phone
(863) 617-9400
Fax
(863) 688-9858
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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 OTA5783 FL Primary

Addresses

Primary practice location

411 E Orange St
Suite 204
Lakeland, FL 33801-5054

Mailing address

411 E Orange St
Suite 204
Lakeland, FL 33801-5054
Phone (863) 617-9400

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
OTA5783FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1720391063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E ORANGE ST",
            "address_2": "SUITE 204",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015054",
            "telephone_number": "863-617-9400",
            "fax_number": "863-688-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E ORANGE ST",
            "address_2": "SUITE 204",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015054",
            "telephone_number": "863-617-9400",
            "fax_number": "863-688-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARRIOR",
        "first_name": "DEBORAH",
        "middle_name": "ANNE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA5783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.