Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT13844 | FL |
N | 225XL0004X | Low Vision | OT13844 | FL |
NPI | 1306152954 |
---|---|
Provider Name | Ms. Bonnie L Avis |
First Address | Sarasota, FL 34231-3622 |
Second Address | Sarasota, FL 34231-3622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2010 |
Last Update Date | 20/08/2010 |