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General NPI Number Information
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NPI Number | 1689822025
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Entity Type | Individual
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Provider Name | YANEH SIMON BENDROSS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 3828 MCELVEEN AVE
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City | PLANT CITY
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State | FL
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Zip | 33566-4160
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Country | US
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Telephone | 813-764-8129
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 HARDEN BLVD # 128
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City | LAKELAND
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State | FL
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Zip | 33803-5938
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Country | US
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Telephone | 137-867-6178
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT13072
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License Number State | FL
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