MEDICARE: MAGGIE DEMETROS OTR

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	O22747	FL

General Provider Information

NPI Number	:	1861355612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGGIE DEMETROS OTR

Provider Business Mailing Address
First Line	:	4108 53RD AVE W APT 218
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 53RD AVE W APT 218
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3445
Country	:	US
Telephone Number	:	207-450-2907
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ MAGGIE DEMETROS OTR” Practice Location

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