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Individual

LAURA B OTTAVIANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
8000 SR 64 E, BRADENTON, FL 34212
(941) 792-1404
(941) 795-1717
Mailing address
8000 SR 64 E, BRADENTON, FL 34212
(941) 792-1404
(941) 795-1717

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS 7921
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285740720
GROUP NPI
FL
01
260048612
RAILROAD MEDICARE
FL
01
46759
BCBS FL
FL
Enumeration date
02/27/2006
Last updated
05/25/2022
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