Provider Demographics
NPI:1679800916
Name:CASTELLANO, LORELL LYNN (OTR)
Entity type:Individual
Prefix:MS
First Name:LORELL
Middle Name:LYNN
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 S PENINSULA DR
Mailing Address - Street 2:UNIT 208
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-4478
Mailing Address - Country:US
Mailing Address - Phone:386-589-7332
Mailing Address - Fax:
Practice Address - Street 1:102 S PENINSULA DR
Practice Address - Street 2:UNIT 208
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-4478
Practice Address - Country:US
Practice Address - Phone:386-589-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT0720225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist