Organization
CANOPY OCCUPATIONAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY MARTIN OTR/L (CEO)
(305) 409-9376
Entity
Organization
Contact information
Practice address
4908 KEY LIME DR UNIT 201, JACKSONVILLE, FL 32256-3270
(305) 409-9376
Mailing address
4908 KEY LIME DR UNIT 201, JACKSONVILLE, FL 32256-3270
(305) 409-9376
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
02/12/2026
Last updated
04/22/2026
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