Active NPI
Holly Bottura
- Pediatric Occupational Therapist
- Clermont, FL
National Provider Identifier
1356961270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 20743
- Practice address
- 2400 S Hwy 27 Ste B201
Clermont, FL 34711-6816 - Phone
- (352) 394-0212
- NPI assigned
- Apr 21, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 20743 | FL | Primary |
Addresses
Primary practice location
2400 S Hwy 27 Ste B201
Clermont, FL 34711-6816
Mailing address
2481 The Oaks Blvd
Kissimmee, FL 34746-3892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20743 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Dreamplex LLC | Pediatrics | Current | Accepting new patients |
| Yakety Yak Speech-Language Pathologists, Inc. | Past | Accepting new patients |
Locations
2400 S US Highway 27
Ste B201
Clermont, FL 34711
Phone (352) 606-0000
2400 S Highway 27
Ste B2
Clermont, FL 34711
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Kissimmee, FL
- NPI 1376867465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1356961270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2481 THE OAKS BLVD",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347463892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 S HWY 27 STE B201",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347116816",
"telephone_number": "352-394-0212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTTURA",
"first_name": "HOLLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-21",
"last_updated": "2022-09-27",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "20743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.