MEDICARE: DINA MARIE PALERMO OTR/L

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	OT5972	FL

General Provider Information

NPI Number	:	1144311614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA MARIE PALERMO OTR/L

Provider Business Mailing Address
First Line	:	19288 LIBERTY RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2643
Country	:	US
Telephone Number	:	561-271-3812
Fax Number	:

Provider Business Practice Location Address
First Line	:	19288 LIBERTY RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-2643
Country	:	US
Telephone Number	:	561-271-3812
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/09/2007

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