MEDICARE: NEXT GENERATION THERAPY, INC.

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

General Provider Information

NPI Number	:	1194003806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXT GENERATION THERAPY, INC.

Provider Business Mailing Address
First Line	:	16969 NW 67TH AVE FL 33015
Second Line	:	SUITE 200
City	:	HIALEAH
State	:	FL
Zip	:	33015-4214
Country	:	US
Telephone Number	:	786-304-9098
Fax Number	:

Provider Business Practice Location Address
First Line	:	16969 NW 67TH AVE FL 33015
Second Line	:	SUITE 200
City	:	HIALEAH
State	:	FL
Zip	:	33015-4214
Country	:	US
Telephone Number	:	786-304-9098
Fax Number	:

Authorized Official
Title or Position	:	OTA
Name	:	MS. MARY CHACON
Credential	:
Telephone Number	:	786-304-9098

Provider Enumeration Date	:	07/29/2011
Last Update Date	:	07/29/2011

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