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NPI Code Detail

MEDICARE: KENNESHIA CROSS

MEDICARE: KENNESHIA CROSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225XG0600XGerontology Occupational Therapist

General Provider Information

NPI Number : 1033703582
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNESHIA CROSS
Provider Business Mailing Address
First Line : 1552 SE FLORESTA DR # 1059
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34983-4069
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1552 SE FLORESTA DR # 1059
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34983-4069
Country : US
Telephone Number : 772-867-3898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2021
Last Update Date : 08/15/2025

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Directions to “ KENNESHIA CROSS ” Practice Location

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