MEDICARE: MR. ALI SATTARI

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	18202	FL

General Provider Information

NPI Number	:	1083140032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALI SATTARI

Provider Business Mailing Address
First Line	:	4158 NW 90TH AVE APT 205
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-1714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1750 N UNIVERSITY DR
Second Line	:	105
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-8903
Country	:	US
Telephone Number	:	954-356-2878
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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