Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyler James Otto

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1770365884

Tyler James Otto is a Student in an Organized Health Care Education/Training Program in Gainesville, Florida. Licensed in Florida. Registered with an NPI since 2023.

Licensed in
FL
In the registry since
2023
Specialties on file
2

Practice location Address checks out

1515 SW Archer Rd
Gainesville, FL 32608-1134
Phone: (612) 816-9003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 7510 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1770365884
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 16, 2023
Last updated in NPPESJune 23, 2025
Certification dateJune 23, 2025
Mailing address611 Nw 34th Dr, Gainesville, FL 32607-2429

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