Organization
LIL SPROUTS PEDIATRIC THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEANNE DEPA OTR/L (OCCUPATIONAL THERAPIST/MGR)
(813) 625-2237
Entity
Organization
Contact information
Practice address
9601 SUNNYOAK DR, RIVERVIEW, FL 33569-5635
(813) 625-2237
Mailing address
9601 SUNNYOAK DR, RIVERVIEW, FL 33569-5635
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884097100
—
FL
Enumeration date
06/27/2016
Last updated
10/29/2021
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