MEDICARE: ASHLEY MEGAN BAKER 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	OT2748	MS
2	225X00000X	Occupational Therapist	OT14793	FL

General Provider Information

NPI Number	:	1831450204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY MEGAN BAKER MS, OTR/L

Provider Business Mailing Address
First Line	:	1300 SHETTER AVE
Second Line	:	APT, 7308
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3455
Country	:	US
Telephone Number	:	386-316-7769
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 PRUDENTIAL DRIVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-1517
Country	:	US
Telephone Number	:	904-390-2000
Fax Number	:

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

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	10/07/2015

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