Individual
THERESA BENEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5323 COTTONWOOD TREE CIR, VALRICO, FL 33596-8258
(813) 655-9468
Mailing address
5323 COTTONWOOD TREE CIR, VALRICO, FL 33596-8258
(813) 655-9468
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 11455
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA 11455
STATE OF FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
05/02/2014
Last updated
05/02/2014
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