Individual
MRS. HEATHER LEIGH DITARANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
11009 THERESA ARBOR DR, TEMPLE TERRACE, FL 33617-3166
(813) 841-7484
(813) 570-6693
Mailing address
17818 MISSION OAK DR, LITHIA, FL 33547-4803
(813) 841-7484
(813) 571-5511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT9497
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11194801
CITRUS HMO
FL
01
—
27529
BCBS
FL
01
—
354933
WELLCARE
FL
01
—
570616636
TRICARE
FL
05
—
885848900
—
FL
Enumeration date
01/11/2007
Last updated
10/01/2019
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