Active NPI
Melissa Governale
- Gerontology Occupational Therapist
- Sanford, FL
National Provider Identifier
1619248408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- OTA 11515
- Practice address
- 2478 River Tree Cir
Sanford, FL 32771-8333 - Phone
- (407) 383-6410
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | OTA 11515 | FL | Primary |
Addresses
Primary practice location
2478 River Tree Cir
Sanford, FL 32771-8333
Mailing address
2478 River Tree Circle
Sanford, FL 32771-8333
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 |
|---|---|---|---|
| OTA 11515 | FL | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1619248408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2478 RIVER TREE CIRCLE",
"city": "SANFORD",
"state": "FL",
"postal_code": "327718333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2478 RIVER TREE CIR",
"city": "SANFORD",
"state": "FL",
"postal_code": "327718333",
"telephone_number": "407-383-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOVERNALE",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "FL",
"license": "OTA 11515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.