MEDICARE: AMANDA ZAGORIA OTD, 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	20771	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	:	1508482100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ZAGORIA OTD, OTR/L

Provider Business Mailing Address
First Line	:	9424 NW 11TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-4806
Country	:	US
Telephone Number	:	954-661-2821
Fax Number	:

Provider Business Practice Location Address
First Line	:	2122 W CYPRESS CREEK RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1858
Country	:	US
Telephone Number	:	954-982-7110
Fax Number	:

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

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	01/17/2021

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