Provider Demographics
NPI:1336513068
Name:BROWN, SCARLET MARIE (OT)
Entity type:Individual
Prefix:
First Name:SCARLET
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SCARLET
Other - Middle Name:MARIE
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:100 MADRID BLVD UNIT 212
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-8928
Mailing Address - Country:US
Mailing Address - Phone:941-646-8510
Mailing Address - Fax:
Practice Address - Street 1:100 MADRID BLVD UNIT 212
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-8928
Practice Address - Country:US
Practice Address - Phone:941-646-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17261225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist