MEDICARE: HAND REHABILITATION SERVICES

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	225XH1200X	Hand Occupational Therapist	OT0000642	FL

General Provider Information

NPI Number	:	1205874278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAND REHABILITATION SERVICES

Provider Business Mailing Address
First Line	:	5847 21ST AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-5641
Country	:	US
Telephone Number	:	941-792-3134
Fax Number	:	941-792-2524

Provider Business Practice Location Address
First Line	:	5847 21ST AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-5641
Country	:	US
Telephone Number	:	941-792-3134
Fax Number	:	941-792-2524

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. VIRGINIA H CLARK
Credential	:	OTR, CHT
Telephone Number	:	941-792-3134

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	08/22/2020

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