Individual
MARIAN PORTER MANDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR.L
Contact information
Practice address
4414 W ANITA BLVD, TAMPA, FL 33611-1116
(813) 789-2419
Mailing address
4414 W ANITA BLVD, TAMPA, FL 33611-1116
(813) 789-2419
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
008847-1N
NY
225XP0200X
Pediatric Occupational Therapist
Primary
OT15452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006735200
—
FL
Enumeration date
06/03/2010
Last updated
01/23/2013
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