Individual
ANNALEEN MARIE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
255 59TH ST N, ST PETERSBURG, FL 33710-8589
(727) 302-3752
Mailing address
4220 53RD AVE W APT 2217, BRADENTON, FL 34210-4406
(904) 894-3080
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15690
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTA15690
—
FL
Enumeration date
01/15/2019
Last updated
01/15/2019
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