MEDICARE: MS. LOURDES GIULIANA OCAMPO OT

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	OT10008	FL

General Provider Information

NPI Number	:	1649320086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOURDES GIULIANA OCAMPO OT

Provider Business Mailing Address
First Line	:	5825 COLLINS AVE
Second Line	:	APT #3-D
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2213
Country	:	US
Telephone Number	:	786-290-6091
Fax Number	:

Provider Business Practice Location Address
First Line	:	5825 COLLINS AVE
Second Line	:	APT #3-D
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2213
Country	:	US
Telephone Number	:	786-290-6091
Fax Number	:

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	07/08/2007

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