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General NPI Number Information
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NPI Number | 1871869354
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Entity Type | Individual
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Provider Name | MRS. RONI JANINE PAULSSON
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Gender | Female
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 815 BRIAR CREEK BLVD NE
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City | PALM BAY
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State | FL
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Zip | 32905-5423
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Country | US
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Telephone | 321-956-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 316 TRINIDAD DR
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City | SATELLITE BEACH
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State | FL
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Zip | 32937-3443
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Country | US
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Telephone | 321-474-5567
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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 | OT11815
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License Number State | FL
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