MEDICARE: REBECCA SAMAAN OTR/L

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	OT0008410	FL

General Provider Information

NPI Number	:	1982927190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SAMAAN OTR/L

Provider Business Mailing Address
First Line	:	2422 SIWARD AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7520
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2422 SIWARD AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7520
Country	:	US
Telephone Number	:	407-658-5767
Fax Number	:

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

Provider Enumeration Date	:	03/03/2010
Last Update Date	:	03/03/2010

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