Provider Demographics
NPI:1609969336
Name:HALL, MARITZA I (OTR)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:I
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 N. STATE ROAD 434
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714
Mailing Address - Country:US
Mailing Address - Phone:407-774-6421
Mailing Address - Fax:407-774-0984
Practice Address - Street 1:995 N. STATE ROAD 434
Practice Address - Street 2:SUITE 405
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714
Practice Address - Country:US
Practice Address - Phone:407-774-6421
Practice Address - Fax:407-774-0984
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1085225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics