MEDICARE: KRISTEN CAROLAN MSOT

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	488171	FL

General Provider Information

NPI Number	:	1063111276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN CAROLAN MSOT

Provider Business Mailing Address
First Line	:	2451 BRICKELL AVE APT 11L
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33129-2469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 SUNSET DR STE 282
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5369
Country	:	US
Telephone Number	:	305-763-8132
Fax Number	:

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

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	01/12/2024

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Directions to “ KRISTEN CAROLAN MSOT” Practice Location

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