Individual
ELIZABETH A FORMY-DUVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5831 BEE RIDGE RD STE 300, SARASOTA, FL 34233-5090
(941) 378-5100
(941) 960-1962
Mailing address
5831 BEE RIDGE RD STE 300, SARASOTA, FL 34233-5090
(941) 782-0102
(941) 794-1863
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT6623
FL
225XH1200X
Hand Occupational Therapist
OT6623
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT6623
STATE LICENSE
FL
Enumeration date
03/19/2007
Last updated
12/10/2019
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