Provider Demographics
NPI:1154800555
Name:HEYNS, DONELLE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:DONELLE
Middle Name:
Last Name:HEYNS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 SW SUNSET TRACE CIR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8105
Mailing Address - Country:US
Mailing Address - Phone:772-223-5509
Mailing Address - Fax:
Practice Address - Street 1:1600 SW CAPRI ST
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-4520
Practice Address - Country:US
Practice Address - Phone:772-223-5863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4826225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist