Healthcare Provider Details

I. General information

NPI: 1841009404
Provider Name (Legal Business Name): AMBER RAI NIPPER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13568 NW 1ST LN STE 1
NEWBERRY FL
32669-3698
US

IV. Provider business mailing address

13568 NW 1ST LN STE 1
NEWBERRY FL
32669-3698
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-9448
  • Fax: 352-331-9621
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25824
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: