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General NPI Number Information
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NPI Number | 1528101243
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Entity Type | Individual
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Provider Name | BONNIE KEATON OTR
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 10168 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3938
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Country | US
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Telephone | 954-753-4441
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Fax | 954-346-8139
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Provider Business Mailing Address
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Address Line | 6063 GRAND CYPRESS CIR W
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2341
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Country | US
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Telephone | 386-697-6430
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Fax | 954-227-5418
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT12463
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License Number State | FL
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