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General NPI Number Information
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NPI Number | 1255940888
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Entity Type | Individual
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Provider Name | JUSTIN LEE CHEVERE OT
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Gender | Male
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2525 EMBASSY DR STE 13
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City | HOLLYWOOD
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State | FL
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Zip | 33026-4573
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Country | US
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Telephone | 754-888-9616
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Fax |
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Provider Business Mailing Address
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Address Line | 4932 NW 105TH DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-1761
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Country | US
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Telephone | 954-913-4107
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT25947
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License Number State | FL
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