MEDICARE: CYNDIE JO-AN SO

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	OT9829	FL

General Provider Information

NPI Number	:	1538253257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNDIE JO-AN SO

Provider Business Mailing Address
First Line	:	10845 SW 112TH AVE APT 216
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3247
Country	:	US
Telephone Number	:	305-962-6163
Fax Number	:

Provider Business Practice Location Address
First Line	:	10845 SW 112TH AVE APT 216
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-3247
Country	:	US
Telephone Number	:	305-962-6163
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/09/2007

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Directions to “ CYNDIE JO-AN SO ” Practice Location

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