MEDICARE: TANA ANDREWS

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	OT8717	FL

General Provider Information

NPI Number	:	1679624852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANA ANDREWS

Provider Business Mailing Address
First Line	:	497 SW DURANT ST
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-3446
Country	:	US
Telephone Number	:	386-208-2959
Fax Number	:

Provider Business Practice Location Address
First Line	:	497 SW DURANT ST
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-3446
Country	:	US
Telephone Number	:	386-208-2959
Fax Number	:

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	07/08/2007

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Directions to “ TANA ANDREWS ” Practice Location

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