Individual provider Active NPI

Frantz Venel Beaubrun, COTA

  • Occupational Therapy Assistant
  • Saint Petersburg, FL
National Provider Identifier
1093488090
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA17180 Issued in FL
Practice address
7101 Dr.Martin Luther King Jr. St. N
Saint Petersburg, FL 33702
Phone
(727) 527-7231
NPI assigned
Jul 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA17180 FL Primary

Addresses

Primary practice location

7101 Dr.Martin Luther King Jr. St. N
Saint Petersburg, FL 33702

Mailing address

7101 Dr.Martin Luther King Jr. St. N
Saint Petersburg, FL 33702
Phone (727) 527-7231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA17180FLMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1093488090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 DR.MARTIN LUTHER KING JR. ST. N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-527-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 DR.MARTIN LUTHER KING JR. ST. N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-527-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUBRUN",
        "first_name": "FRANTZ",
        "middle_name": "VENEL",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.