Healthcare Provider Details

I. General information

NPI: 1124975420
Provider Name (Legal Business Name): KAITLYN GUPPY OTR/L, CSRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2026
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 NW SPRUCE RIDGE DR
STUART FL
34994-9535
US

IV. Provider business mailing address

723 NW SPRUCE RIDGE DR
STUART FL
34994-9535
US

V. Phone/Fax

Practice location:
  • Phone: 315-558-8252
  • Fax:
Mailing address:
  • Phone: 315-558-8252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT15436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: