Individual provider Active NPI

Susan Rotunno

  • Occupational Therapy Assistant
  • Kissimmee, FL
National Provider Identifier
1396359741
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA17503 Issued in FL
Practice address
2511 N John Young Pkwy
Kissimmee, FL 34741-1653
Phone
(407) 931-3336
NPI assigned
Sep 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 OTA17503 FL Primary

Addresses

Primary practice location

2511 N John Young Pkwy
Kissimmee, FL 34741-1653

Mailing address

7343 W Sand Lake Rd Apt 546
Orlando, FL 32819-5308

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
OTA17503FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1396359741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7343 W SAND LAKE RD APT 546",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347411653",
            "telephone_number": "407-931-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTUNNO",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA17503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.