Active NPI
Trevor Blose
- Occupational Therapist
- St Petersburg, FL
National Provider Identifier
1508574195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT23648
- Practice address
- 3456 21St Ave S
St Petersburg, FL 33711-3213 - Phone
- (727) 327-1988
- NPI assigned
- Nov 11, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT23648 | FL | Primary |
Addresses
Primary practice location
3456 21St Ave S
St Petersburg, FL 33711-3213
Mailing address
540 Carillon Pkwy Apt 3120
St Petersburg, FL 33716-1293
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT23648 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668124800000",
"number": "1508574195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 CARILLON PKWY APT 3120",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337161293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3456 21ST AVE S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337113213",
"telephone_number": "727-327-1988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOSE",
"first_name": "TREVOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-11",
"last_updated": "2022-11-11",
"certification_date": "2022-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT23648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
- Bloom at St. Petersburg, LLC (Bloom at St. Pete)
- Bloom Into Balance Psychiatry & Wellness, PLLC
- Bloom Therapy Center of St. Pete, LLC
- Bernard Bloom
- Steven Bloom, DDS
- Nancy Beth Bloss Tumarkin, M.D.
- Sonja Katherine Blosser, PTA
- Blossom Family Chiropractic
- Blossom Medical Center Corp
- Blossoming Wellbeing Corp.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.