Individual provider Active NPI

Maricela Isabel Henlon, COTA-L

  • Occupational Therapy Assistant
  • Orlando, FL
National Provider Identifier
1396392262
Registry record updated Aug 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
16945 Issued in FL
Practice address
6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593
Phone
(407) 970-0825
Fax
(321) 235-5506
NPI assigned
Aug 24, 2019
Last updated
Aug 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2019

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 16945 FL Primary

Addresses

Primary practice location

6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593

Mailing address

15108 Moultrie Pointe Rd
Orlando, FL 32828-6656
Phone (407) 617-0168

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
16945FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566604800000",
    "number": "1396392262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15108 MOULTRIE POINTE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286656",
            "telephone_number": "407-617-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277593",
            "telephone_number": "407-970-0825",
            "fax_number": "321-235-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLON",
        "first_name": "MARICELA",
        "middle_name": "ISABEL",
        "name_prefix": "Miss",
        "credential": "COTA-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-24",
        "last_updated": "2019-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "16945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2019; 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.