MEDICARE: MS. DEBRA LYNN OCKER PH.D.

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	174400000X	Specialist	0022088	FL

General Provider Information

NPI Number	:	1841356276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA LYNN OCKER PH.D.

Provider Business Mailing Address
First Line	:	319 FILLMORE AVE
Second Line	:
City	:	CAPE CANAVERAL
State	:	FL
Zip	:	32920-3126
Country	:	US
Telephone Number	:	321-456-5080
Fax Number	:	321-456-5067

Provider Business Practice Location Address
First Line	:	1395 N COURTENAY PKWY STE 206
Second Line	:
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-4475
Country	:	US
Telephone Number	:	321-456-5080
Fax Number	:	321-456-5067

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	07/08/2007

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