Provider Demographics
NPI:1316138977
Name:THOMBRE, USHA (OTR)
Entity type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:THOMBRE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:USHA
Other - Middle Name:
Other - Last Name:THOMBRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:2120 MARSHALL EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6731
Mailing Address - Country:US
Mailing Address - Phone:863-534-1862
Mailing Address - Fax:863-533-5458
Practice Address - Street 1:2120 MARSHALL EDWARDS DR
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6731
Practice Address - Country:US
Practice Address - Phone:863-534-1862
Practice Address - Fax:863-533-5458
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10735225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist