Potter, Lidu Ivette

Potter, Lidu Ivette is an individual health care provider with primary practice located at 971 Virginia Ave Suite A, Palm Harbor FL 34683-5235. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Potter, Lidu Ivette can be contacted via phone (727) 773-2687.

Contact Information

Primary practice address
971 Virginia Ave Suite A Palm Harbor FL 34683-5235
Phone: (727) 773-2687
Fax: (727) 773-2742
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT10194 Florida

Profile Details

NPI number 1013024686
LBN Legal business name Potter, Lidu Ivette
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Aug 9th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013024686 NPPES
Florida MEDICAID 887471900

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