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NPI Code Detail

MEDICARE: MS. STEPHANIE EMMA TATEM-PAIGE MOTR/L

MEDICARE: MS. STEPHANIE EMMA TATEM-PAIGE MOTR/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
1225X00000XOccupational TherapistOT17705FL

General Provider Information

NPI Number : 1366950115
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE EMMA TATEM-PAIGE MOTR/L
Provider Business Mailing Address
First Line : 17523 DORIS ST
Second Line :
City : MONTVERDE
State : FL
Zip : 34756-3167
Country : US
Telephone Number : 352-615-5230
Fax Number :
Provider Business Practice Location Address
First Line : 617 W DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-2602
Country : US
Telephone Number : 352-805-4404
Fax Number : 352-805-4407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2018
Last Update Date : 07/10/2024

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