MEDICARE: MRS. SEJAL PATEL MS, 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	225X00000X	Occupational Therapist	OT 11952	FL

General Provider Information

NPI Number	:	1770555039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SEJAL PATEL MS, OTR/L

Provider Business Mailing Address
First Line	:	9654 VIA GRANDEZZA E
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33411-6507
Country	:	US
Telephone Number	:	561-414-3143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 N DIXIE HWY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6250
Country	:	US
Telephone Number	:	561-585-4881
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/09/2007

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