MEDICARE: MS. ARIANA WATSON 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	225XP0200X	Pediatric Occupational Therapist	OT10950	FL

General Provider Information

NPI Number	:	1639240583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ARIANA WATSON OTR L

Provider Business Mailing Address
First Line	:	1910 GARVIN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-3350
Country	:	US
Telephone Number	:	407-257-8289
Fax Number	:

Provider Business Practice Location Address
First Line	:	5423 LAKE HOWELL RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-1033
Country	:	US
Telephone Number	:	407-679-7837
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/09/2007

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