Individual provider Active NPI

Sandra Ollervides

  • Occupational Therapist
  • Homestead, FL
National Provider Identifier
1699893404
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT11954 Issued in FL
Practice address
633 SE 30TH Ter
Homestead, FL 33033-7178
Phone
(786) 280-1511
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT11954 FL Primary

Addresses

Primary practice location

633 SE 30TH Ter
Homestead, FL 33033-7178

Mailing address

633 SE 30TH Ter
Homestead, FL 33033-7178
Phone (786) 280-1511

Other practice location 1

1331 NE 42nd Ave
Homestead, FL 33033-5862
Phone (305) 776-6539

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
OT11954FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1699893404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 SE 30TH TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337178",
            "telephone_number": "786-280-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 SE 30TH TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337178",
            "telephone_number": "786-280-1511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 NE 42nd Ave",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330335862",
            "country_code": "US",
            "telephone_number": "305-776-6539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLLERVIDES",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT11954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.