Organization
CAROL E TIETZOTR/LPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL E TIETZ OTR L (OWNER)
(727) 809-3326
Entity
Organization
Contact information
Practice address
10521 HEARTH RD, SPRING HILL, FL 34608-3714
(727) 375-0600
(727) 375-1117
Mailing address
6325 MONTANA AVE, NEW PORT RICHEY, FL 34653-3833
(727) 809-3326
(727) 845-1811
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT1010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10655701
CITRUS HEALTHCARE NPR
FL
01
—
10655802
CITRUS HEALTHCARE SH
FL
05
—
885427100
—
FL
Enumeration date
02/09/2007
Last updated
02/06/2019
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