MEDICARE: DR. KELLY JOANNE MCCUE OTD, OTR/L, COMT UL

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	OT20655	FL

General Provider Information

NPI Number	:	1811522576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY JOANNE MCCUE OTD, OTR/L, COMT UL

Provider Business Mailing Address
First Line	:	932 OAKFIELD DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4950
Country	:	US
Telephone Number	:	813-654-1410
Fax Number	:

Provider Business Practice Location Address
First Line	:	932 OAKFIELD DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4950
Country	:	US
Telephone Number	:	813-654-1410
Fax Number	:

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

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	04/06/2026

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