Healthcare Provider Details

I. General information

NPI: 1922352038
Provider Name (Legal Business Name): PUTTENTIAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 WINTER GARDEN VINELAND RD STE 112
WINTER GARDEN FL
34787-4449
US

IV. Provider business mailing address

1222 WINTER GARDEN VINELAND RD STE 112
WINTER GARDEN FL
34787-4449
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-0029
  • Fax: 407-358-5207
Mailing address:
  • Phone: 407-877-0029
  • Fax: 407-358-5207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CHARITY HIGGINS
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTR/L
Phone: 954-594-2822