Most Relevant Information
Provider Data
| NPI Number: | 1003316274 |
| Provider Name: | TYLER SCOTT LACERTOSA OTD |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 18954 |
Most Important Dates
| Enumeration Date: | 02/14/2018 |
| Last Updated: | 02/14/2018 |
Provider Practice Location
201 N CLYDE MORRIS BLVD STE 300
DAYTONA BEACH
FL
321142765
Practice Location Phone/Fax
| Phone: | 3862367017 |
| Fax: |
Provider Mailing Location
3901 UNIVERSITY BLVD S
JACKSONVILLE
FL
322164312
Provider Mailing Phone/Fax
| Phone: | 9043457336 |
| Fax: |