Individual
AZENITH CASUPANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
701 LAKE PORT BLVD, LEESBURG, FL 34748-7674
(352) 728-3366
(352) 435-0206
Mailing address
38921 HARBORWOODS PL, LADY LAKE, FL 32159-6056
(443) 813-9498
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT15464
FL
Other
Enumeration date
10/17/2008
Last updated
12/09/2022
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