MEDICARE: MS. SHANA SYMONE QUARRIE 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	174N00000X	Lactation Consultant (Non-RN)	L-311312
2	225X00000X	Occupational Therapist	OT15517	FL

General Provider Information

NPI Number	:	1689910283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHANA SYMONE QUARRIE OTR/L

Provider Business Mailing Address
First Line	:	3232 SOMERSET PARK DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-7340
Country	:	US
Telephone Number	:	786-302-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	10967 LAKE UNDERHILL RD STE 138
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-4455
Country	:	US
Telephone Number	:	786-302-8400
Fax Number	:

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

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	06/14/2023

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