Individual
JOHN DESARAJ PRABHAKARIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12760 WESTWOOD LAKES BLVD, TAMPA, FL 33626-2345
(813) 855-9791
Mailing address
12760 WESTWOOD LAKES BLVD, TAMPA, FL 33626-2345
(813) 855-9791
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OT2852
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884490900
—
FL
Enumeration date
02/21/2007
Last updated
01/15/2009
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