Provider Demographics
NPI:1336469014
Name:EDMUNDS, NAOMI S (OT)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:S
Last Name:EDMUNDS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:SACHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:7520 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-7611
Mailing Address - Country:US
Mailing Address - Phone:352-505-6339
Mailing Address - Fax:352-505-6340
Practice Address - Street 1:7520 W UNIVERSITY AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-7611
Practice Address - Country:US
Practice Address - Phone:352-505-6339
Practice Address - Fax:352-505-6340
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12602225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics