Provider Demographics
NPI:1538917679
Name:HOTZ, ALLISON P (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:P
Last Name:HOTZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 DAVENPORT BRIDGE LN APT 212
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-2368
Mailing Address - Country:US
Mailing Address - Phone:734-309-1217
Mailing Address - Fax:
Practice Address - Street 1:1819 PROVIDENCE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-1899
Practice Address - Country:US
Practice Address - Phone:813-657-8587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21267225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist