MEDICARE: M.E.G. THERAPIES, LLC

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	OT13372	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

General Provider Information

NPI Number	:	1104161702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M.E.G. THERAPIES, LLC

Provider Business Mailing Address
First Line	:	600 NE 36TH ST
Second Line	:	#1417
City	:	MIAMI
State	:	FL
Zip	:	33137-3929
Country	:	US
Telephone Number	:	786-201-2426
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 NE 36TH ST
Second Line	:	#1417
City	:	MIAMI
State	:	FL
Zip	:	33137-3929
Country	:	US
Telephone Number	:	786-201-2426
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MEGAN BALKENBUSH
Credential	:	MS, OTR/L
Telephone Number	:	786-201-2426

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	12/07/2012

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