Most Relevant Information
Provider Data
| NPI Number: | 1003567769 |
| Provider Name: | GINA MARIE LASTELLA OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | OT22582 |
Most Important Dates
| Enumeration Date: | 01/14/2022 |
| Last Updated: | 01/14/2022 |
Provider Practice Location
880 PATRICIA AVE
DUNEDIN
FL
346986072
Practice Location Phone/Fax
| Phone: | 7278031102 |
| Fax: |
Provider Mailing Location
260 1ST AVE S STE 200
SAINT PETERSBURG
FL
337014364
Provider Mailing Phone/Fax
| Phone: | 7278031102 |
| Fax: | 7275026027 |