MEDICARE: ROBYN COLLEY 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	0008386	FL

General Provider Information

NPI Number	:	1689980179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN COLLEY OT

Provider Business Mailing Address
First Line	:	1180 SPRING CENTRE SOUTH BLVD STE 201
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1955
Country	:	US
Telephone Number	:	407-493-2435
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 SPRING CENTRE SOUTH BLVD
Second Line	:	SUITE 201
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1974
Country	:	US
Telephone Number	:	407-493-2435
Fax Number	:	407-982-3357

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

Provider Enumeration Date	:	08/23/2010
Last Update Date	:	06/04/2013

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