MEDICARE: CAROL MCCAUSLIN

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	225100000X	Physical Therapist	18607	FL

General Provider Information

NPI Number	:	1063226587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MCCAUSLIN

Provider Business Mailing Address
First Line	:	243 CEDAR AVE
Second Line	:
City	:	COCOA BEACH
State	:	FL
Zip	:	32931-2825
Country	:	US
Telephone Number	:	321-501-2421
Fax Number	:

Provider Business Practice Location Address
First Line	:	3490 GRAN AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-6044
Country	:	US
Telephone Number	:	321-426-1785
Fax Number	:

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

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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Directions to “ CAROL MCCAUSLIN ” Practice Location

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