Individual provider Active NPI

Rosannie Acevedo

  • Pediatric Occupational Therapist
  • Immokalee, FL
National Provider Identifier
1891287876
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT17561 Issued in FL
Practice address
429 N 1St St
Immokalee, FL 34142-3150
Phone
(239) 254-4280
Fax
(239) 468-7954
NPI assigned
Jun 5, 2018
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X FL
Pediatric Occupational Therapist 225XP0200X OT17561 FL Primary

Addresses

Primary practice location

429 N 1St St
Immokalee, FL 34142-3150

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 254-4280

Other practice location 1

14391 Metropolis Ave Ste 101
Fort Myers, FL 33912-4423
Phone (239) 561-2778

Other identifiers 1

IdentifierTypeStateIssuer
100007300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190211001012 FL Practitioner - Occupational Therapist in Private Practice 0446598858 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Nov 21, 2018 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Nov 21, 2018 Accepting new patients

Locations

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1891287876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-254-4280",
            "fax_number": "239-468-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N 1ST ST",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341423150",
            "telephone_number": "239-254-4280",
            "fax_number": "239-468-7954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14391 Metropolis Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124423",
            "country_code": "US",
            "telephone_number": "239-561-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "ROSANNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT17561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Immokalee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; 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.