MEDICARE: MS. LYNNE MELLO 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	225X00000X	Occupational Therapist	OT2369	FL

General Provider Information

NPI Number	:	1548366693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNNE MELLO OTR/L

Provider Business Mailing Address
First Line	:	2823 28TH CT
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33477-9366
Country	:	US
Telephone Number	:	561-743-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	11947 SOUTHERN BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-7619
Country	:	US
Telephone Number	:	561-204-2213
Fax Number	:

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	07/08/2007

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