MEDICARE: DEBORAH KAY STONE OTA

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	A000495	FL

General Provider Information

NPI Number	:	1457484404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH KAY STONE OTA

Provider Business Mailing Address
First Line	:	5241 NICHOLS DR E
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-4077
Country	:	US
Telephone Number	:	863-409-6481
Fax Number	:

Provider Business Practice Location Address
First Line	:	8800 GRAND OAK CIR
Second Line	:	SUITE 450
City	:	TAMPA
State	:	FL
Zip	:	33637-2006
Country	:	US
Telephone Number	:	863-409-6481
Fax Number	:	813-975-1016

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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