MEDICARE: JOYCE ROSALES

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	OT20053	FL

General Provider Information

NPI Number	:	1639889009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE ROSALES

Provider Business Mailing Address
First Line	:	5285 SUMMERLIN RD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-7601
Country	:	US
Telephone Number	:	954-408-1920
Fax Number	:	941-907-8599

Provider Business Practice Location Address
First Line	:	5285 SUMMERLIN RD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-7601
Country	:	US
Telephone Number	:	954-408-1920
Fax Number	:	941-907-8599

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

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	11/28/2022

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Directions to “ JOYCE ROSALES ” Practice Location

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