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NPI Code Detail

MEDICARE: TANYA TUCKMAN OTR/L

MEDICARE: TANYA TUCKMAN 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
1225X00000XOccupational Therapist
2225XL0004XLow Vision Occupational Therapist
3225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1194979682
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA TUCKMAN OTR/L
Provider Business Mailing Address
First Line : 3268 MARBON RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-3218
Country : US
Telephone Number : 904-886-2997
Fax Number : 904-216-0471
Provider Business Practice Location Address
First Line : 3268 MARBON RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-3218
Country : US
Telephone Number : 904-886-2997
Fax Number : 904-216-0471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2008
Last Update Date : 11/10/2008

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Directions to “ TANYA TUCKMAN OTR/L” Practice Location

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