Provider Demographics
NPI:1396913513
Name:HYUN, SANDY (OTR/L)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:HYUN
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 1:31615 MARCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5122
Mailing Address - Country:US
Mailing Address - Phone:813-355-4124
Mailing Address - Fax:813-355-4124
Practice Address - Street 1:37411 EILAND BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-1800
Practice Address - Country:US
Practice Address - Phone:813-778-4898
Practice Address - Fax:813-355-4124
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12805225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist