MEDICARE: CONSTANCE BONIS OT

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
1	225X00000X	Occupational Therapist	OT9022	FL

General Provider Information

NPI Number	:	1275463416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE BONIS OT

Provider Business Mailing Address
First Line	:	955 MAEMIR WAY
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4601
Country	:	US
Telephone Number	:	866-718-5757
Fax Number	:	866-718-5759

Provider Business Practice Location Address
First Line	:	7777 N UNIVERSITY DR STE 101S
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-6106
Country	:	US
Telephone Number	:	866-718-5757
Fax Number	:	866-718-5759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ CONSTANCE BONIS OT” Practice Location

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