Healthcare Provider Details

I. General information

NPI: 1528590114
Provider Name (Legal Business Name): SAMANTHA BELL MOT, OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 HAULOVER DR
ALTAMONTE SPRINGS FL
32714-7539
US

IV. Provider business mailing address

823 HAULOVER DR
ALTAMONTE SPRINGS FL
32714-7539
US

V. Phone/Fax

Practice location:
  • Phone: 407-383-2039
  • Fax:
Mailing address:
  • Phone: 407-383-2039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT17899
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: