Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA15241 | FL |
NPI | 1023563103 |
---|---|
Provider Name | Amy Simeone |
First Address | Naples, FL 34109-2023 |
Second Address | Naples, FL 34109-2023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2016 |
Last Update Date | 18/08/2016 |