MEDICARE: AMY GIDDENS OT/L

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	222Q00000X	Developmental Therapist
2	225X00000X	Occupational Therapist	OT9701	FL

General Provider Information

NPI Number	:	1326930629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY GIDDENS OT/L

Provider Business Mailing Address
First Line	:	3261 US HIGHWAY 441/27 STE B3
Second Line	:
City	:	FRUITLAND PARK
State	:	FL
Zip	:	34731-4492
Country	:	US
Telephone Number	:	352-323-0612
Fax Number	:

Provider Business Practice Location Address
First Line	:	3261 US HIGHWAY 441/27 STE B3
Second Line	:
City	:	FRUITLAND PARK
State	:	FL
Zip	:	34731-4492
Country	:	US
Telephone Number	:	352-323-0612
Fax Number	:

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

Provider Enumeration Date	:	07/19/2025
Last Update Date	:	07/25/2025

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