Healthcare Provider Details

I. General information

NPI: 1275187304
Provider Name (Legal Business Name): REBECCA J ORNER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA J MINSAL

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26551 NW 3RD AVE
NEWBERRY FL
32669-5319
US

IV. Provider business mailing address

26551 NW 3RD AVE
NEWBERRY FL
32669-5319
US

V. Phone/Fax

Practice location:
  • Phone: 786-636-4351
  • Fax:
Mailing address:
  • Phone: 786-636-4351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT20234
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number20234
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: