MEDICARE: CARLA URSO OTR

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	OT3613	FL

General Provider Information

NPI Number	:	1134263395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA URSO OTR

Provider Business Mailing Address
First Line	:	PO BOX 323
Second Line	:
City	:	WINTER BEACH
State	:	FL
Zip	:	32971-0323
Country	:	US
Telephone Number	:	772-559-3831
Fax Number	:

Provider Business Practice Location Address
First Line	:	4307 US HIGHWAY 1
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-1504
Country	:	US
Telephone Number	:	772-559-3831
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/08/2007

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Directions to “ CARLA URSO OTR” Practice Location

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