Ezra David Ndolo, OT
Individual provider Active NPI Occupational Therapist · Oxford, FL
NPI 1598074098 · NPPES record last updated Sep 30, 2010
Key facts
- NPI
- 1598074098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT11661 (FL)
- Practice address
- 10780 N US Highway 301
Oxford, FL 34484-3505 - Phone
- (352) 330-3900
- NPI assigned
- Sep 30, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT11661 | FL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT11661 | FL | Yes |
Addresses
Primary practice location
10780 N US Highway 301
Oxford, FL 34484-3505
Mailing address
2222 Sullivan TRL
Easton, PA 18040-7958
Phone (800) 944-9782
Other providers in Oxford, FL
- Jennifer Danielle Montgomery
- Skylah Ronice Morrow
- Stella Munizzi
- My Residence Care Place LLC
- Natural Therapy Group, LLC
- Arnaldo Ogerio
- Shire Maria Padao
- Passport Health Holdings, LLC
- Presence Psychotherapy LLC
- Preventive Nephrology, PA
All providers in Oxford, FL · Occupational Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.