MEDICARE: ANA MARIA COLON O.T.R.

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 2117	FL

General Provider Information

NPI Number	:	1568432417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARIA COLON O.T.R.

Provider Business Mailing Address
First Line	:	8867 NW 108TH ST
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4508
Country	:	US
Telephone Number	:	305-466-1388
Fax Number	:

Provider Business Practice Location Address
First Line	:	2962C AVENTURA BLVD
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-3103
Country	:	US
Telephone Number	:	305-466-1388
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	06/12/2013

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