Provider Demographics
NPI:1790772077
Name:PEPE, DONNA W (OT, CHT, CLT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:W
Last Name:PEPE
Suffix:
Gender:F
Credentials:OT, CHT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4896 SILVERTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6326
Mailing Address - Country:US
Mailing Address - Phone:203-578-0336
Mailing Address - Fax:
Practice Address - Street 1:30669 US HIGHWAY 19 N STE 409
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4410
Practice Address - Country:US
Practice Address - Phone:727-377-2129
Practice Address - Fax:138-967-8524
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18489225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400282479Medicare PIN