MEDICARE: SEBASTIAN KAZMIERCZAK OTD, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811532203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEBASTIAN KAZMIERCZAK OTD, OTR/L

Provider Business Mailing Address
First Line	:	11066 WINTER CREST DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-2015
Country	:	US
Telephone Number	:	216-905-9413
Fax Number	:

Provider Business Practice Location Address
First Line	:	5035 E BUSCH BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-5310
Country	:	US
Telephone Number	:	813-631-9700
Fax Number	:

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

Provider Enumeration Date	:	11/09/2019
Last Update Date	:	11/09/2019

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