Healthcare Provider Details

I. General information

NPI: 1811670896
Provider Name (Legal Business Name): ALORA DAWN WEBER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 ISABELLA BLVD STE 10
JACKSONVILLE BEACH FL
32250-8002
US

IV. Provider business mailing address

2730 ISABELLA BLVD STE 10
JACKSONVILLE BEACH FL
32250-8002
US

V. Phone/Fax

Practice location:
  • Phone: 904-372-4070
  • Fax:
Mailing address:
  • Phone: 904-372-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number24413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: