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NPI Code Detail

MEDICARE: MRS. SUSAN LYNN KAUPAS OTR

MEDICARE:  MRS. SUSAN LYNN KAUPAS  OTR
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 TherapistOT18120FL

General Provider Information

NPI Number : 1386131563
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN LYNN KAUPAS OTR
Provider Business Mailing Address
First Line : 4942 GRAND BANKS DR
Second Line :
City : WIMAUMA
State : FL
Zip : 33598-4127
Country : US
Telephone Number : 972-816-0393
Fax Number :
Provider Business Practice Location Address
First Line : 231 COURTYARD BLVD
Second Line :
City : SUN CITY CENTER
State : FL
Zip : 33573-5759
Country : US
Telephone Number : 813-603-6255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2018
Last Update Date : 04/13/2018

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Directions to “ MRS. SUSAN LYNN KAUPAS OTR” Practice Location

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