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NPI Code Detail

MEDICARE: MRS. CRISTINA P SIMMONS MSOT, OTR/L

MEDICARE: MRS. CRISTINA P SIMMONS MSOT, 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 TherapistFL

General Provider Information

NPI Number : 1376299586
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRISTINA P SIMMONS MSOT, OTR/L
Provider Business Mailing Address
First Line : 7141 BUSTED OAKS WAY
Second Line :
City : BUSHNELL
State : FL
Zip : 33513-2204
Country : US
Telephone Number : 352-973-2982
Fax Number :
Provider Business Practice Location Address
First Line : 619 W DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-2602
Country : US
Telephone Number : 352-805-4404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2022
Last Update Date : 08/30/2023

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