Larry James Gronholm
Occupational Therapy Assistant
621 Raymond Loop
Auburndale
, Florida 33823-2899
Larry James Gronholm
Occupational Therapy Assistant
621 Raymond Loop
Auburndale
, Florida 33823-2899
(863) 307-4142
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About
Features
Specialties
- Occupational Therapy Assistant
Languages spoken
- English
Location
First Address
- Larry James Gronholm
- 621 Raymond Loop
- Auburndale, FL
- Zip : 33823-2899
- Phone : (863) 307-4142
Second Address
- Larry James Gronholm
- 621 Raymond Loop
- Auburndale, FL
- Zip : 33823-2899
- Phone : (863) 307-4142
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | OTA13579 | FL |
National Provider Identifier
| NPI | 1013468305 |
|---|---|
| Provider Name | Larry James Gronholm |
| First Address | Auburndale, FL 33823-2899 |
| Second Address | Auburndale, FL 33823-2899 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/10/2016 |
| Last Update Date | 20/10/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 325120 | NBCOT (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.