MEDICARE: MICHELLE KERBY OTR

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	174400000X	Specialist	OT60028677	WA
2	225XP0200X	Pediatric Occupational Therapist	OT23178	FL

General Provider Information

NPI Number	:	1851541023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE KERBY OTR

Provider Business Mailing Address
First Line	:	5206 COVESOUND WAY
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-3328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5206 COVESOUND WAY
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-3328
Country	:	US
Telephone Number	:	813-502-1794
Fax Number	:	877-814-9122

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

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	10/27/2022

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Directions to “ MICHELLE KERBY OTR” Practice Location

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