MEDICARE: SAVERIO CUSUMANO 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	OT7386	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OT7386	OTHER	FL	STATE LICENSE

General Provider Information

NPI Number	:	1659402493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVERIO CUSUMANO OT

Provider Business Mailing Address
First Line	:	326 SW 66TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2928
Country	:	US
Telephone Number	:	786-218-3106
Fax Number	:	305-261-9557

Provider Business Practice Location Address
First Line	:	326 SW 66TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2928
Country	:	US
Telephone Number	:	786-218-3106
Fax Number	:	305-261-9557

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	01/28/2009

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