MEDICARE: MICHELLE JACQUELINE TROUP

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	OT17250	FL

General Provider Information

NPI Number	:	1093280216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE JACQUELINE TROUP

Provider Business Mailing Address
First Line	:	22030 BOCA PLACE DR APT 627
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-8006
Country	:	US
Telephone Number	:	574-527-3681
Fax Number	:

Provider Business Practice Location Address
First Line	:	3275 W HILLSBORO BLVD STE 210
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9476
Country	:	US
Telephone Number	:	954-428-4707
Fax Number	:

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

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	10/04/2018

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Directions to “ MICHELLE JACQUELINE TROUP ” Practice Location

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