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NPI Code Detail

MEDICARE: ELAINE HERRIN OTA

MEDICARE: ELAINE HERRIN OTA
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
1224Z00000XOccupational Therapy AssistantOTA16665FL

General Provider Information

NPI Number : 1255818217
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINE HERRIN OTA
Provider Business Mailing Address
First Line : 787 37TH ST STE E100
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-7304
Country : US
Telephone Number : 772-569-9747
Fax Number : 772-569-9979
Provider Business Practice Location Address
First Line : 787 37TH ST STE E100
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-7304
Country : US
Telephone Number : 772-569-9747
Fax Number : 772-569-9747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 07/23/2018

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Directions to “ ELAINE HERRIN OTA” Practice Location

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