MEDICARE: RAQUEL OLMO OT/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	13220	FL

General Provider Information

NPI Number	:	1710130786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL OLMO OT/L

Provider Business Mailing Address
First Line	:	272 LINBERRY LN
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4440
Country	:	US
Telephone Number	:	407-353-4475
Fax Number	:

Provider Business Practice Location Address
First Line	:	6924 W LINEBAUGH AVE
Second Line	:	CHILDREN'S CHOICE FOR THERAPY INC.
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-962-6766
Fax Number	:

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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