Healthcare Provider Details

I. General information

NPI: 1871183798
Provider Name (Legal Business Name): NADIA MOHAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S HWY 27 STE B201
CLERMONT FL
34711-6816
US

IV. Provider business mailing address

PO BOX 120547
CLERMONT FL
34712-0547
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-0212
  • Fax: 352-241-6361
Mailing address:
  • Phone: 352-394-0212
  • Fax: 352-241-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT21468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: