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General NPI Number Information
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NPI Number | 1730365578
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Entity Type | Individual
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Provider Name | ALICIA SPENCE
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 7380 W SAND LAKE RD STE 500
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City | ORLANDO
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State | FL
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Zip | 32819-5257
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Country | US
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Telephone | 407-905-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 7017 TALBOT DR
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City | ORLANDO
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State | FL
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Zip | 32819-7440
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Country | US
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Telephone | 979-595-5049
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 304603
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License Number State | TX
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