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General NPI Number Information
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NPI Number | 1528834660
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Entity Type | Organization
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Legal Business Name | BOTES MEMORY METHOD
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 9617 NW 143RD ST
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City | ALACHUA
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State | FL
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Zip | 32615-7687
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Country | US
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Telephone | 352-359-0739
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Fax |
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Provider Business Mailing Address
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Address Line | 9617 NW 143RD ST
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City | ALACHUA
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State | FL
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Zip | 32615-7687
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Country | US
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Telephone | 352-359-0739
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SIRA NEL BOTES
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Credential | OTR/L
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Telephone | 352-359-0739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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