MEDICARE: OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QH0100X	Health Service Clinic/Center
3	261QX0100X	Occupational Medicine Clinic/Center

General Provider Information

NPI Number	:	1295392785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST P.A.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DR STE 1200W
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-4624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 OLD TAMPA HWY
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-1135
Country	:	US
Telephone Number	:	863-413-8360
Fax Number	:	863-413-8369

Authorized Official
Title or Position	:	VP
Name	:	ROBERT G HASSETT
Credential	:
Telephone Number	:	972-364-8000

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	12/19/2023

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