Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT10413 | FL |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT10413 | FL |
NPI | 1902018435 |
---|---|
Provider Name | Brian David Hinaman |
First Address | Clearwater, FL 33763-1321 |
Second Address | Clearwater, FL 33763-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
830063100 | (05) | FL |
887992300 | (05) | FL |