Active NPI
Samantha S Wadas, OTR/L
- Occupational Therapist
- Bonita Springs, FL
National Provider Identifier
1124649512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT15403
- Practice address
- Solaris Rehab, LLC
9520 Bonita Beach Rd SE
Bonita Springs, FL 34135 - Phone
- (239) 514-2310
- NPI assigned
- Apr 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT15403 | FL | Primary |
Addresses
Primary practice location
Solaris Rehab, LLC
9520 Bonita Beach Rd SE
Bonita Springs, FL 34135
Mailing address
7220 Swan Lake Dr
Fort Myers, FL 33919-7007
Phone (352) 316-3475
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT15403 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1124649512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7220 SWAN LAKE DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339197007",
"telephone_number": "352-316-3475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SOLARIS REHAB, LLC",
"address_2": "9520 BONITA BEACH RD SE",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "34135",
"telephone_number": "239-514-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADAS",
"first_name": "SAMANTHA",
"middle_name": "S",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-27",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT15403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.