MEDICARE: DOREEN DUGGAN OTRPA

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	225X00000X	Occupational Therapist	OT9462	FL

General Provider Information

NPI Number	:	1487872701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOREEN DUGGAN OTRPA

Provider Business Mailing Address
First Line	:	1823 N J ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6541
Country	:	US
Telephone Number	:	561-859-9221
Fax Number	:	561-237-5442

Provider Business Practice Location Address
First Line	:	1823 N J ST
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6541
Country	:	US
Telephone Number	:	561-859-9221
Fax Number	:	561-237-5442

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	DOREEN DUGGAN
Credential	:	OT
Telephone Number	:	561-859-9221

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/22/2020

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