Provider Demographics
NPI:1962741546
Name:RATNASAMY, JOHN B (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:B
Last Name:RATNASAMY
Suffix:
Gender:M
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 1:6027 ARLINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1300
Mailing Address - Country:US
Mailing Address - Phone:321-751-1785
Mailing Address - Fax:
Practice Address - Street 1:6027 ARLINGTON CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-1300
Practice Address - Country:US
Practice Address - Phone:321-751-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5168225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology