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NPI Code Detail

MEDICARE: AMBER ALEXANDREA GAVINS

MEDICARE: AMBER ALEXANDREA GAVINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant13889FL

General Provider Information

NPI Number : 1043602279
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER ALEXANDREA GAVINS
Provider Business Mailing Address
First Line : 1735 VINEYARD WAY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32317-7914
Country : US
Telephone Number : 850-228-0859
Fax Number :
Provider Business Practice Location Address
First Line : 1735 VINEYARD WAY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32317-7914
Country : US
Telephone Number : 850-228-0859
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2015
Last Update Date : 02/25/2015

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Directions to “ AMBER ALEXANDREA GAVINS ” Practice Location

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