MEDICARE: MR. VINCENT JOSEPH ZEOLI 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	OT8527	FL

General Provider Information

NPI Number	:	1679814859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT JOSEPH ZEOLI OTR/L

Provider Business Mailing Address
First Line	:	10408 BRIGANTINE BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3639
Country	:	US
Telephone Number	:	813-690-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	4624 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2706
Country	:	US
Telephone Number	:	813-874-2646
Fax Number	:	813-874-2656

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

Provider Enumeration Date	:	03/12/2013
Last Update Date	:	03/12/2013

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