MEDICARE: JOHN ANOTHONY DE PIERO 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
1	225X00000X	Occupational Therapist	OT 2613	FL

General Provider Information

NPI Number	:	1548504376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANOTHONY DE PIERO OTR

Provider Business Mailing Address
First Line	:	8523 BRAMWELL WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1704
Country	:	US
Telephone Number	:	813-979-1288
Fax Number	:

Provider Business Practice Location Address
First Line	:	8523 BRAMWELL WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1704
Country	:	US
Telephone Number	:	813-979-1288
Fax Number	:

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

Provider Enumeration Date	:	11/16/2012
Last Update Date	:	11/16/2012

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