Provider Demographics
NPI:1427731603
Name:MCDONALD, AMBER (COTA/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 FOXHILL CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8168
Mailing Address - Country:US
Mailing Address - Phone:407-619-3479
Mailing Address - Fax:
Practice Address - Street 1:13574 VILLAGE PARK DR STE 250
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7696
Practice Address - Country:US
Practice Address - Phone:407-391-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA18185224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant