MEDICARE: KATHRYN G HART

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	OT18763	FL

General Provider Information

NPI Number	:	1811405756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN G HART

Provider Business Mailing Address
First Line	:	5603 EASTWIND DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-5076
Country	:	US
Telephone Number	:	941-539-3295
Fax Number	:	855-232-8604

Provider Business Practice Location Address
First Line	:	5603 EASTWIND DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-5076
Country	:	US
Telephone Number	:	941-539-3295
Fax Number	:	855-232-8604

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

Provider Enumeration Date	:	01/12/2018
Last Update Date	:	01/12/2018

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