MEDICARE: MR. CHRISTOPHER SCOTT HIGBY OT

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	225X00000X	Occupational Therapist	OT4593	FL

General Provider Information

NPI Number	:	1366400905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER SCOTT HIGBY OT

Provider Business Mailing Address
First Line	:	6500 BOWDEN RD
Second Line	:	STE 103
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8066
Country	:	US
Telephone Number	:	850-588-6852
Fax Number	:	850-588-6847

Provider Business Practice Location Address
First Line	:	10800 PANAMA CITY BEACH PKWY
Second Line	:	SUITE 100
City	:	PANAMA CITY
State	:	FL
Zip	:	32407-2533
Country	:	US
Telephone Number	:	850-588-6852
Fax Number	:	850-588-6847

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/15/2019

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