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Individual

OTASH BARRETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
13156 ROYAL PINES AVE, RIVERVIEW, FL 33579-9321
(813) 516-7886
Mailing address
13156 ROYAL PINES AVE, RIVERVIEW, FL 33579-9321
(813) 516-7886

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B630643750190
FL

Other

Enumeration date
01/30/2024
Last updated
01/30/2024
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