Healthcare Provider Details

I. General information

NPI: 1972641348
Provider Name (Legal Business Name): CARYN CHENVEN MS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2771 EXECUTIVE PARK DR STE 6
WESTON FL
33331-3644
US

IV. Provider business mailing address

PO BOX 290370
FT LAUDERDALE FL
33329-0370
US

V. Phone/Fax

Practice location:
  • Phone: 954-745-1112
  • Fax:
Mailing address:
  • Phone: 954-262-4346
  • Fax: 954-262-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT10990
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: