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NPI Code Detail

MEDICARE: MICHELLE SUZANNE ANTONI M.S. OTR/L CHT

MEDICARE: MICHELLE SUZANNE ANTONI M.S. OTR/L CHT
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
1225X00000XOccupational TherapistOT13266FL
2225XH1200XHand Occupational Therapist121137TX

General Provider Information

NPI Number : 1750668828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE SUZANNE ANTONI M.S. OTR/L CHT
Provider Business Mailing Address
First Line : 801 BAYSHORE DR.
Second Line :
City : INGLESIDE
State : TX
Zip : 78362
Country : US
Telephone Number : 543-042-5029
Fax Number :
Provider Business Practice Location Address
First Line : 1008 ENTERPRISE BLVD
Second Line :
City : ROCKPORT
State : TX
Zip : 78382-3201
Country : US
Telephone Number : 361-727-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2011
Last Update Date : 09/21/2020

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