MEDICARE: KAREN MICHELLE MIZRACHI OTRL

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
1	225X00000X	Occupational Therapist	OT10835	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053318394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MICHELLE MIZRACHI OTRL

Provider Business Mailing Address
First Line	:	6966 NW 66TH AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33067-1409
Country	:	US
Telephone Number	:	954-895-0461
Fax Number	:

Provider Business Practice Location Address
First Line	:	6966 NW 66TH AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33067-1409
Country	:	US
Telephone Number	:	954-895-0461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	10/02/2023

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