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General NPI Number Information
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NPI Number | 1649493099
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Entity Type | Individual
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Provider Name | MAREK GRACZKOWSKI OTR
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23315 BLUE WATER CIR
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City | BOCA RATON
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State | FL
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Zip | 33433-7053
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Country | US
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Telephone | 561-368-1033
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Fax |
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Provider Business Mailing Address
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Address Line | 2850 SOMERSET DR L 218
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311-9342
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Country | US
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Telephone | 954-295-0726
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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 | OT10388
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License Number State | FL
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