Braden Hostetler
Individual provider Active NPI Occupational Therapist · Heathrow, FL
NPI 1639424898 · NPPES record last updated Jul 13, 2012
Key facts
- NPI
- 1639424898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4976 (AZ)
- Practice address
- 1525 International Pkwy
Heathrow, FL 32746-7644 - Phone
- (800) 798-6035
- NPI assigned
- Jul 13, 2012
- 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 |
|---|---|---|---|
| 4976 | AZ | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4976 | AZ | Yes |
Addresses
Primary practice location
1525 International Pkwy
Heathrow, FL 32746-7644
Mailing address
1525 International Pkwy
Heathrow, FL 32746-7644
Phone (800) 798-6035
Other providers in Heathrow, FL
- Everett Harris
- Brenda Nicole Hawkins
- Angela Hays
- Margaret Hogle
- Margaree Gaynell Hood
- Stanley Houston
- Lila Hurst
- Cyndi Anne Hyde
- David L Hyde
- Kelly Isenhoff
All providers in Heathrow, 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 Jul 13, 2012. 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.