MEDICARE: BHAKTI REDDY OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	22603	FL
2	225X00000X	Occupational Therapist	013679	NY

General Provider Information

NPI Number	:	1699028563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAKTI REDDY OTR/L

Provider Business Mailing Address
First Line	:	8435 LANDER ST APT 4C
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-2016
Country	:	US
Telephone Number	:	714-515-9621
Fax Number	:

Provider Business Practice Location Address
First Line	:	14707 SPEER LAKE DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-8870
Country	:	US
Telephone Number	:	714-515-9621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	01/24/2022

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Directions to “ BHAKTI REDDY OTR/L” Practice Location

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