Healthcare Provider Details

I. General information

NPI: 1033074216
Provider Name (Legal Business Name): JAVED AMIR MOHAMMED OTD, OTR/L, CSRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TYRONE BLVD N
SAINT PETERSBURG FL
33710-6309
US

IV. Provider business mailing address

2621 11TH ST N
SAINT PETERSBURG FL
33704-2605
US

V. Phone/Fax

Practice location:
  • Phone: 727-231-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT23015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: