Suzanne Stephanie Glaze, OTD, OTRL, CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT-3084 Issued in FL

Practice address

9 Pine Cone Dr
Suite 104-B
Palm Coast, FL 32137-8686

Phone

(386) 446-9716

Fax

(386) 446-0046

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Optimum HealthCare HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Genesis Health Development Inc

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1033154992
  Medicare reassignment

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1720127491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PINE CONE DR",
            "address_2": "SUITE 104-B",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378686",
            "telephone_number": "386-446-9716",
            "fax_number": "386-446-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZE",
        "first_name": "SUZANNE",
        "middle_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "OTD, OTRL, CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT-3084",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "OT-3084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Taylor Gillespie
• Ashley Gilmore, FNP-C
• Allison Dawkins Gimbert, DC
• Sean Gimbert, D.C.
• Jalen Glasper
• Kelsey Agostini Gocking
• Robert Carl Goetsch Jr., RMHCI
• Golden Age House Assisted Living LLC
• Golden Health Practitioners Inc.
• Golden House Assisted Living Inc.

• Hand Occupational Therapist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Hand Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.