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NPI Code Detail

MEDICARE: BARBARA ANNETTE DIVINCENZO OTR/L

MEDICARE:   BARBARA ANNETTE DIVINCENZO  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
1225X00000XOccupational TherapistOT 2674FL
2225XH1200XHand Occupational TherapistOT 2674FL
3225XN1300XNeurorehabilitation Occupational TherapistOT 2674FL
4225XP0200XPediatric Occupational TherapistOT 2674FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z6251OTHERFLBLUE CROSS & BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3OT 2674OTHERFLSTATE LICENSE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235172859
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA ANNETTE DIVINCENZO OTR/L
Provider Business Mailing Address
First Line : 911 N SPRING GARDEN AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-2560
Country : US
Telephone Number : 386-736-3108
Fax Number : 386-736-3643
Provider Business Practice Location Address
First Line : 911 N SPRING GARDEN AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-2560
Country : US
Telephone Number : 386-736-3108
Fax Number : 386-736-3643
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 09/11/2025

Similar Medicare Providers

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1124061213 — LEIGH A DELGADO RPT
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Directions to “ BARBARA ANNETTE DIVINCENZO OTR/L” Practice Location

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