Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 19036 | FL |
NPI | 1003313420 |
---|---|
Provider Name | Amanda Mercedes Hoss |
First Address | Windermere, FL 34786-9493 |
Second Address | Orlando, FL 32819-5257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2018 |
Last Update Date | 11/04/2018 |