MEDICARE: MARIA TERESA DE CARVALHO

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	OT19177	FL

General Provider Information

NPI Number	:	1710478599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA TERESA DE CARVALHO

Provider Business Mailing Address
First Line	:	1249 COOSA AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-1144
Country	:	US
Telephone Number	:	954-410-8900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1249 COOSA AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-1144
Country	:	US
Telephone Number	:	954-410-8900
Fax Number	:

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

Provider Enumeration Date	:	05/28/2018
Last Update Date	:	05/28/2018

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Directions to “ MARIA TERESA DE CARVALHO ” Practice Location

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