Provider Demographics
NPI:1972603611
Name:PYATT, BARBARA D (OT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:D
Last Name:PYATT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7107
Mailing Address - Country:US
Mailing Address - Phone:239-540-5560
Mailing Address - Fax:239-540-0270
Practice Address - Street 1:3636 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7107
Practice Address - Country:US
Practice Address - Phone:239-540-5560
Practice Address - Fax:239-540-0270
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ047NZMedicare PIN