Provider Demographics
NPI:1912384777
Name:SPEIGHTS, AMANDA (DHSC, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:SPEIGHTS
Suffix:
Gender:F
Credentials:DHSC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 METROPICA WAY APT 1608
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3231
Mailing Address - Country:US
Mailing Address - Phone:305-457-5551
Mailing Address - Fax:
Practice Address - Street 1:2000 METROPICA WAY APT 1608
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3231
Practice Address - Country:US
Practice Address - Phone:305-457-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 16986.225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015212000Medicaid