MEDICARE: MRS. JOSEE SCULLY

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	225XH1200X	Hand Occupational Therapist	6113	FL

General Provider Information

NPI Number	:	1083910061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOSEE SCULLY

Provider Business Mailing Address
First Line	:	430 MORTON PLANT ST STE 101
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3397
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 MORTON PLANT ST STE 101
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3397
Country	:	US
Telephone Number	:	727-462-7237
Fax Number	:

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

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	02/08/2011

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Directions to “ MRS. JOSEE SCULLY ” Practice Location

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