MEDICARE: MRS. KIMBERLY ANN HOUSNI MS,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	225X00000X	Occupational Therapist	OT16432	FL
2	224Z00000X	Occupational Therapy Assistant	OP002765L	PA
3	225X00000X	Occupational Therapist	OC011676	PA

General Provider Information

NPI Number	:	1679725725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY ANN HOUSNI MS,OTR/L

Provider Business Mailing Address
First Line	:	1710 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6508
Country	:	US
Telephone Number	:	813-876-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6508
Country	:	US
Telephone Number	:	813-876-7400
Fax Number	:

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	07/14/2016

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