MEDICARE: MRS. DEBORAH NICOLE BOJAN MSOTR/L

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	225X00000X	Occupational Therapist	OT12324	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OT12324	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1063685782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH NICOLE BOJAN MSOTR/L

Provider Business Mailing Address
First Line	:	3826 NORTHLAKE BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1503
Country	:	US
Telephone Number	:	561-625-2775
Fax Number	:	561-625-2776

Provider Business Practice Location Address
First Line	:	3826 NORTHLAKE BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1503
Country	:	US
Telephone Number	:	561-625-2775
Fax Number	:	561-625-2776

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

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	04/03/2008

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