MEDICARE: COURI S TAYLOR M.S., OTR/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	OT14384	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215230404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURI S TAYLOR M.S., OTR/L

Provider Business Mailing Address
First Line	:	1045 NW 128TH TER
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33168-6530
Country	:	US
Telephone Number	:	305-502-1876
Fax Number	:

Provider Business Practice Location Address
First Line	:	11285 SW 211TH ST
Second Line	:	SUITE 204
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2211
Country	:	US
Telephone Number	:	786-293-3933
Fax Number	:

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

Provider Enumeration Date	:	12/10/2010
Last Update Date	:	12/10/2010

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