MR. TRAVIS LEWELLEN OTTO (NPI# 1093065955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093065955 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS LEWELLEN OTTO |
| Credential | PSY.D. |
| Practice Address |
2505 Crowder Ln Tampa FL 33629-6253 |
| Mailing Address |
6225 Willet Ct Lakewood Ranch FL 34202-8224 |
| Practice Telephone | 8133614809 |
| Mailing Telephone | 8133614809 |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY8595 | FL | Behavioral Health & Social Service Providers |
| Street Address |
2505 CROWDER LN |
| City | TAMPA |
| State | FL |
| Zip Code | 33629-6253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162612 | Jake Morris | Counselor | 4003 W Morrison Ave, Tampa, FL 33629 | 2018-04-25 |
| 1689192411 | Madalyn Turner | Chiropractor | 3409 W Bay To Bay Blvd Ste B, Tampa, FL 33629 | 2017-08-31 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1093198160 | Mi Ae Kwon | Dentist | 3739 W. Neptune St., Tampa, FL 33629 | 2015-07-07 |
| 1013394568 | Etairos Health, Inc | In Home Supportive Care | 2301 W Palm Ave, Tampa, FL 33629 | 2015-05-05 |
| 1053702589 | Kantilal N. Bhadja, Md | Internal Medicine | 4223 W. El Prado Blvd, Tampa, FL 33629 | 2015-02-05 |
| 1801174016 | Wang & Cortes Dental | Dentist | 1008 South Clearview Avenue, Tampa, FL 33629 | 2011-07-22 |
| 1174826176 | Jada Rae Danielle Traub | Behavioral Analyst | 3271 S. Macdill Ave, Tampa, FL 33629 | 2010-12-13 |
| 1275849846 | Kara Dawson | Physical Therapy Assistant | 3614 South Dale Mabry, Tampa, FL 33629 | 2010-08-20 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| Find all providers in zip 33629 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744327 | Lisa Stewart | Psychologist | 13000 Bruce B Downs Blvd Bldg 68, Tampa, FL 33612-4745 | 2020-09-15 |
| 1205488012 | Kimberly Hubinger | Psychologist | 3825 Henderson Blvd Ste 505c, Tampa, FL 33629-5037 | 2019-07-11 |
| 1528537362 | Bethan Anne Roberts | Psychologist | 13000 Bruce B Downs Blvd Rm 163, Tampa, FL 33612-4745 | 2018-11-23 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1962979583 | Rosana Marzullo-dove | Psychologist | 912 W Platt St Ste 101, Tampa, FL 33606-2108 | 2018-11-01 |
| 1740764158 | Fabian Alexandro Consbruck | Psychologist | 5425 Beaumont Center Blvd Ste 918, Tampa, FL 33634-5214 | 2018-09-20 |
| 1154810802 | Lashley Marks | Psychologist | 4202 E Fowler Ave Stop Svc2124, Tampa, FL 33620-6970 | 2018-05-08 |
| 1922595305 | Carmen Ana Gonzalez-magaz | Psychologist | 836 S Davis Blvd, Tampa, FL 33606-4025 | 2018-04-20 |
| 1811494982 | Adam Zimmer | Psychologist | 4202 E Fowler Ave Shs 100, Tampa, FL 33620-6750 | 2018-04-06 |
| 1326553389 | My Psychology Place Inc. | Psychologist | 6601 Memorial Hwy Ste 310, Tampa, FL 33615-4501 | 2017-12-12 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.