David Joseph Banta, OTR/L
Individual provider Active NPI Pediatric Occupational Therapist · Rockledge, FL
NPI 1013371806 · NPPES record last updated Jun 4, 2018
Key facts
- NPI
- 1013371806
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- OT 17634 (FL)
- Practice address
- 2260 Bridgeport Cir
Rockledge, FL 32955-4344 - Phone
- (321) 427-0046
- NPI assigned
- Apr 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 17634 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whiting Pediatric Therapy Services, LLC. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT 17634 | FL | Yes |
Addresses
Primary practice location
2260 Bridgeport Cir
Rockledge, FL 32955-4344
Mailing address
2260 Bridgeport Cir
Rockledge, FL 32955-4344
Phone (321) 427-0046
Other practice location 1
1140 7th Ct
Vero Beach, FL 32960-5706
Phone (772) 584-3888
Other providers in Rockledge, FL
- Cheryl Bailey
- Michael Peter Bailey
- Nicole Bairossi
- Amy L Balog
- Caylee Jacquelyn Banta
- Derrick Banyard Jr.
- Theresa Barcus
- Robert E Barden
- Nikki Barnett
- Nageh S. Barsoum
All providers in Rockledge, FL · Pediatric Occupational Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.