Provider Demographics
NPI:1194207209
Name:BONGIOVANNI, ROBIN HANCOCK (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:HANCOCK
Last Name:BONGIOVANNI
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 1:2410 JENNIFER HOPE BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4726
Mailing Address - Country:US
Mailing Address - Phone:407-443-5389
Mailing Address - Fax:
Practice Address - Street 1:500 VILLAGE PL
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-6171
Practice Address - Country:US
Practice Address - Phone:407-682-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT-7918225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology