MEDICARE: MRS. CAROL SUE ADAMS OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist	OT1109	FL

General Provider Information

NPI Number	:	1023029451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL SUE ADAMS OTR

Provider Business Mailing Address
First Line	:	1725 HERITAGE TRL
Second Line	:	SUITE 301
City	:	NAPLES
State	:	FL
Zip	:	34112-8716
Country	:	US
Telephone Number	:	239-390-1656
Fax Number	:	239-390-1686

Provider Business Practice Location Address
First Line	:	1725 HERITAGE TRL
Second Line	:	SUITE 301
City	:	NAPLES
State	:	FL
Zip	:	34112-8716
Country	:	US
Telephone Number	:	239-390-1656
Fax Number	:	239-390-1686

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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