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General NPI Number Information
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NPI Number | 1477835551
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Entity Type | Individual
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Provider Name | THOMAS DARE OT
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Gender | Male
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 4129 SE 2ND AVE.
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City | CAPE CORAL
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State | FL
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Zip | 33904
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Country | US
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Telephone | 270-562-0811
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Fax | 270-562-0811
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Provider Business Mailing Address
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Address Line | 4129 SE 2ND AVE
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City | CAPE CORAL
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State | FL
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Zip | 33904-8466
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Country | US
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Telephone |
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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 | OT3680
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License Number State | TN
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