Individual provider · NPI-1

Biancah Alexandra Derival, OTD, OTR/L

Occupational Therapist · Port Saint Lucie, FL

NPI number1174420392
StatusActive
Last updated in NPPESOct 21, 2026

Details

NPI
1174420392
Entity type
Individual (NPI-1)
Name
Biancah Alexandra Derival
Credential
OTD, OTR/L
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 21, 2026
Certification date
Oct 21, 2026
Last updated
Oct 21, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational TherapistOT26095FLYes

Practice location

1860 Sw Fountainview Blvd Ste 100-2003
Port Saint Lucie, FL 34986-4535

Phone 407-469-5110

Mailing address

4639 Jetty St
Orlando, FL 32817-3182

Phone 321-230-4666

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