Healthcare Provider Details

I. General information

NPI: 1386088631
Provider Name (Legal Business Name): AMY VON EDWINS MOT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 N STATE ROAD 434 STE 1128
ALTAMONTE SPRINGS FL
32714-7061
US

IV. Provider business mailing address

990 N STATE ROAD 434 STE 1128
ALTAMONTE SPRINGS FL
32714-7061
US

V. Phone/Fax

Practice location:
  • Phone: 321-842-3967
  • Fax: 321-842-3968
Mailing address:
  • Phone: 321-842-3967
  • Fax: 321-842-3968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT15527
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 15527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: