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NPI Code Detail

MEDICARE: MRS. KARLY ANNE FISHER OTR-L

MEDICARE: MRS. KARLY ANNE FISHER 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
1225XP0200XPediatric Occupational Therapist8899CA

General Provider Information

NPI Number : 1275661217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARLY ANNE FISHER OTR-L
Provider Business Mailing Address
First Line : 2403 E HENRY AVE
Second Line :
City : TAMPA
State : FL
Zip : 33610-4434
Country : US
Telephone Number : 813-988-7633
Fax Number :
Provider Business Practice Location Address
First Line : 2403 E HENRY AVE
Second Line :
City : TAMPA
State : FL
Zip : 33610-4434
Country : US
Telephone Number : 813-988-7633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/23/2012

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