MEDICARE: SEAN DARL KERR 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
1	225XH1200X	Hand Occupational Therapist	OT 6268	FL

General Provider Information

NPI Number	:	1376648436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN DARL KERR OTR/L

Provider Business Mailing Address
First Line	:	1915 SW 82ND AVE
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-5427
Country	:	US
Telephone Number	:	954-336-1295
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E HALLANDALE BEACH BLVD
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4432
Country	:	US
Telephone Number	:	954-454-7575
Fax Number	:	954-454-8288

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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