MEDICARE: PATRIZIA F CIUFO-LOPEZ OTRL

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	171W00000X	Contractor	OT6885	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OT 6885	OTHER	FL	OT LICENSE

General Provider Information

NPI Number	:	1639336605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRIZIA F CIUFO-LOPEZ OTRL

Provider Business Mailing Address
First Line	:	3975 VILLAGE DR
Second Line	:	UNIT D
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-2961
Country	:	US
Telephone Number	:	561-900-6254
Fax Number	:	561-498-0733

Provider Business Practice Location Address
First Line	:	3975 VILLAGE DR
Second Line	:	UNIT D
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-2961
Country	:	US
Telephone Number	:	561-900-6254
Fax Number	:	561-498-0733

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	09/21/2009

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