MEDICARE: VALERIE EDMANDS 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	225X00000X	Occupational Therapist	OT1226	FL

General Provider Information

NPI Number	:	1134260292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE EDMANDS OTR

Provider Business Mailing Address
First Line	:	19901 NW 239TH PL
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-7016
Country	:	US
Telephone Number	:	352-256-5581
Fax Number	:	386-454-1383

Provider Business Practice Location Address
First Line	:	19901 NW 239TH PL
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-7016
Country	:	US
Telephone Number	:	352-256-5581
Fax Number	:	386-454-1383

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

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	07/08/2007

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