MEDICARE: DEBRA HAAS

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	224Z00000X	Occupational Therapy Assistant	OP001451L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OP001451L	OTHER	PA	STATE LIC

General Provider Information

NPI Number	:	1396904355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA HAAS

Provider Business Mailing Address
First Line	:	3687 TAMPA RD STE 200
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-6313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3687 TAMPA RD STE 200
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-6313
Country	:	US
Telephone Number	:	813-471-0152
Fax Number	:

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

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	04/20/2015

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Directions to “ DEBRA HAAS ” Practice Location

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