Individual
MRS. AMANDA LYNN ALONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4450 W EAU GALLIE BLVD, MELBOURNE, FL 32934-7213
(321) 255-6627
Mailing address
1980 BARTON BLVD, ROCKLEDGE, FL 32955-6117
(321) 403-0746
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10167
FL
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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