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NPI Code Detail

MEDICARE: KEANA PARKER OTR/L

MEDICARE: KEANA PARKER 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 TherapistOT23581FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OT23581OTHERFLOT LICENSE

General Provider Information

NPI Number : 1598480030
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEANA PARKER OTR/L
Provider Business Mailing Address
First Line : 3955 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4814
Country : US
Telephone Number : 772-257-3621
Fax Number :
Provider Business Practice Location Address
First Line : 3955 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4814
Country : US
Telephone Number : 772-257-3621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2022
Last Update Date : 02/06/2025

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Directions to “ KEANA PARKER OTR/L” Practice Location

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