Organization
TAMPA BAY PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE KOLANKO OTR/L (OWNER/SOLE MBR)
(304) 374-1252
Entity
Organization
Contact information
Practice address
1807 PEPPERTREE DR, OLDSMAR, FL 34677-2741
(304) 374-1252
Mailing address
16025 MUIRFIELD DR, ODESSA, FL 33556-2861
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT14203
FL
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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