Organization
LAVIE REHAB.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA PATRICIA TYRELL (OCCUPATIONAL THERAPIST ASSISTANT)
(813) 382-8001
Entity
Organization
Contact information
Practice address
103 MELANIE LANE, BRANDON, FL 33510
(813) 382-8001
Mailing address
103 MELANIE LANE, BRANDON, FL 33510
(813) 382-8001
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
OTA6727
FL
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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