Individual
TYLER JAMES OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 SW ARCHER RD, GAINESVILLE, FL 32608-1134
(612) 816-9003
Mailing address
611 NW 34TH DR, GAINESVILLE, FL 32607-2429
(612) 816-9003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7510
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/16/2023
Last updated
06/23/2025
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