Healthcare Provider Details

I. General information

NPI: 1063536753
Provider Name (Legal Business Name): ERIC SZYMONSKI OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9461 BATEY AVE
ELK GROVE CA
95624-2005
US

IV. Provider business mailing address

5201 CONGRESS AVE STE 160
BOCA RATON FL
33487-3629
US

V. Phone/Fax

Practice location:
  • Phone: 916-685-9525
  • Fax:
Mailing address:
  • Phone: 561-998-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0690
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number103430
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: