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General NPI Number Information
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NPI Number | 1437636578
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Entity Type | Individual
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Provider Name | JUNE ANNETTE DOUGLAS
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Gender | Female
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Dates
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Enumeration Date | 07/22/2018
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Last Update Date | 07/22/2018
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Provider Practice Location Address
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Address Line | 5201 DESOTO RD
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City | SARASOTA
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State | FL
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Zip | 34235-3607
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Country | US
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Telephone | 941-256-2609
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SAN LINO CIR UNIT 123
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City | VENICE
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State | FL
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Zip | 34292-6314
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Country | US
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Telephone | 941-224-7426
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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 | OT2843
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License Number State | FL
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