Individual
LAUREL L BAXLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
425 SW 14TH ST, OCALA, FL 34474-3215
(352) 351-8300
(352) 351-8310
Mailing address
425 SW 14TH ST, OCALA, FL 34474-3215
(352) 351-8300
(352) 351-8310
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-8330
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR77413160002
CIGNA PROVIDER #
FL
01
—
SG083062
VISTA HEALTHPLAN PROV #
FL
01
—
Z0614
BCBS NON-PAR PROV #
FL
Enumeration date
12/04/2006
Last updated
07/09/2007
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