MEDICARE: MS. DEBRA SUSAN CELLUCCI 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	225X00000X	Occupational Therapist	OT2995	FL

General Provider Information

NPI Number	:	1871704494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA SUSAN CELLUCCI OTR

Provider Business Mailing Address
First Line	:	3702 GREENERY CT
Second Line	:	#202
City	:	TAMPA
State	:	FL
Zip	:	33618-4419
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14517 BRUCE B DOWNS BLVD
Second Line	:	ST #201
City	:	TAMPA
State	:	FL
Zip	:	33613-2755
Country	:	US
Telephone Number	:	813-228-2761
Fax Number	:	813-225-7048

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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