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NPI 1164571915

NPI 1164571915 : GINA L DEMEO OTR L INC : CLEARWATER, FL

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General NPI Number Information
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    NPI Number           |    1164571915
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    Entity Type          |    Organization 
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    Legal Business Name  |    GINA L DEMEO OTR L INC 
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Dates
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    Enumeration Date     |    01/10/2007
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    Last Update Date     |    04/20/2008
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Provider Practice Location Address
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    Address Line         |    3012 SANDPIPER PL 
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    City                 |    CLEARWATER
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    State                |    FL
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    Zip                  |    33762-3060
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    Country              |    US
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    Telephone            |    727-368-2691
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3012 SANDPIPER PL 
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    City                 |    CLEARWATER
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    State                |    FL
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    Zip                  |    33762-3060
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    Country              |    US
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    Telephone            |    727-368-2691
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     GINE  DEMEO 
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    Credential           |    OT
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    Telephone            |    727-368-2691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    
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    License Number State |    
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