Individual provider Active NPI

Alejandra Reyes, COTA/L

  • Occupational Therapy Assistant
  • Melbourne, FL
National Provider Identifier
1336590918
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA14974 Issued in FL
Practice address
115 Crown Blvd
Melbourne, FL 32901-8624
Phone
(929) 394-6289
NPI assigned
Jun 25, 2016
Reactivated
Sep 23, 2025
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 008926-1 NY
Occupational Therapy Assistant 224Z00000X OTA14974 FL Primary

Addresses

Primary practice location

115 Crown Blvd
Melbourne, FL 32901-8624

Mailing address

115 Crown Blvd
Melbourne, FL 32901-8624
Phone (929) 394-6289

Other practice location 1

336 W 37th St
Ste 880
New York, NY 10018-4212
Phone (212) 226-7965

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
OTA14974FLMDOccupational Therapy Assistant
008926-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1336590918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CROWN BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018624",
            "telephone_number": "929-394-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CROWN BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018624",
            "telephone_number": "929-394-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 W 37th St",
            "address_2": "STE 880",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100184212",
            "country_code": "US",
            "telephone_number": "212-226-7965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "ALEJANDRA",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-25",
        "last_updated": "2025-09-23",
        "deactivation_date": "2025-09-04",
        "reactivation_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "008926-1",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA14974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.