Individual
CRYSTAL LOTUS SIERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10300 4TH ST N, ST PETERSBURG, FL 33716-3810
(727) 568-1000
Mailing address
PO BOX 8563, SEMINOLE, FL 33775-8563
(727) 776-3137
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12346
FL
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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