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Individual

MRS. HEATHER LEIGH DITARANTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

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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