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NPI Code Detail

MEDICARE: MRS. KARLA JO VANBEEK MSOTR

MEDICARE: MRS. KARLA JO VANBEEK MSOTR
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
1225X00000XOccupational Therapist9508FL

General Provider Information

NPI Number : 1568681393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARLA JO VANBEEK MSOTR
Provider Business Mailing Address
First Line : 4218 32ND LN E
Second Line :
City : BRADENTON
State : FL
Zip : 34208-7361
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6305 CORTEZ RD W
Second Line :
City : BRADENTON
State : FL
Zip : 34210-2604
Country : US
Telephone Number : 941-761-3499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 07/08/2007

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