MEDICARE: MRS. KAREN JOY FROST O.T.R.

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	225XP0200X	Pediatric Occupational Therapist	420	FL

General Provider Information

NPI Number	:	1336269919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN JOY FROST O.T.R.

Provider Business Mailing Address
First Line	:	10400 SW 122ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-4714
Country	:	US
Telephone Number	:	305-235-5407
Fax Number	:	305-235-5407

Provider Business Practice Location Address
First Line	:	10400 SW 122ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-4714
Country	:	US
Telephone Number	:	305-235-5407
Fax Number	:	305-235-5407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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