# CANOPY OCCUPATIONAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194677930
- **Authorized official:** KELLEY MARTIN OTR/L (CEO)
- **Authorized official phone:** (305) 409-9376

## Contact information

- **Practice address:** 4908 KEY LIME DR UNIT 201, JACKSONVILLE, FL 32256-3270
- **Practice address phone:** (305) 409-9376
- **Mailing address:** 4908 KEY LIME DR UNIT 201, JACKSONVILLE, FL 32256-3270
- **Mailing address phone:** (305) 409-9376

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XE0001X | Environmental Modification Occupational Therapist | — | NULL | — |
| 225XE0001X | Environmental Modification Occupational Therapist | — | — | — |
| 225XH1200X | Hand Occupational Therapist | — | NULL | — |
| 225XH1200X | Hand Occupational Therapist | — | — | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | NULL | Yes |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | — | Yes |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 02/12/2026
- **Last updated:** 04/22/2026