Provider Demographics
NPI:1144488867
Name:CRISLER, PATRICK TIMOTHY (OTA 6857)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:TIMOTHY
Last Name:CRISLER
Suffix:
Gender:M
Credentials:OTA 6857
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3589 E GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-3208
Mailing Address - Country:US
Mailing Address - Phone:352-860-2222
Mailing Address - Fax:352-860-2223
Practice Address - Street 1:3589 E GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3208
Practice Address - Country:US
Practice Address - Phone:352-860-2222
Practice Address - Fax:352-860-2223
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA6857224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant