MEDICARE: ANGELA AUERBACH

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	6451	FL

General Provider Information

NPI Number	:	1073054516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA AUERBACH

Provider Business Mailing Address
First Line	:	5101 SW 113 AVENUE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33330
Country	:	US
Telephone Number	:	954-680-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 SW 113TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33330-2826
Country	:	US
Telephone Number	:	954-680-0626
Fax Number	:

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

Provider Enumeration Date	:	03/16/2017
Last Update Date	:	03/16/2017

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Directions to “ ANGELA AUERBACH ” Practice Location

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