Individual
ANGELA ROSENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
716 E BELLA VISTA ST, LAKELAND, FL 33805-3009
(863) 683-6504
Mailing address
1428 PICCADILLY PL, LAKELAND, FL 33803-1883
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 11338
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889430200
—
FL
Enumeration date
12/03/2013
Last updated
12/03/2013
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