Healthcare Provider Details

I. General information

NPI: 1376648436
Provider Name (Legal Business Name): SEAN DARL KERR OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-4432
US

IV. Provider business mailing address

1915 SW 82ND AVE
DAVIE FL
33324-5427
US

V. Phone/Fax

Practice location:
  • Phone: 954-454-7575
  • Fax: 954-454-8288
Mailing address:
  • Phone: 954-336-1295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT 6268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: