Individual provider Active NPI

Gloriangeles Soule, OT

  • Occupational Therapist
  • Lake Mary, FL
National Provider Identifier
1306171442
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13511 Issued in FL
Practice address
400 International Pkwy
Lake Mary, FL 32746-5061
Phone
(407) 732-5848
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT13511 FL Primary

Addresses

Primary practice location

400 International Pkwy
Lake Mary, FL 32746-5061

Mailing address

442 Wekiva Cove Rd
Longwood, FL 32779-5600
Phone (352) 317-0206

Other practice location 1

900 Lpga Blvd
Daytona Beach, FL 32117-3113
Phone (386) 226-9000

Other names 1

  • Gloria Juarez Former name

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
OT13511FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1306171442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 WEKIVA COVE RD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795600",
            "telephone_number": "352-317-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL PKWY",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465061",
            "telephone_number": "407-732-5848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Lpga Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321173113",
            "country_code": "US",
            "telephone_number": "386-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOULE",
        "first_name": "GLORIANGELES",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT13511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "JUAREZ",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.