MEDICARE: LAUREN ADAMS

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	OT11655	FL
2	225XP0200X	Pediatric Occupational Therapist	OT11655	FL

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
2	Z094Q	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891862470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ADAMS

Provider Business Mailing Address
First Line	:	3776 CROWN POINT COURT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257
Country	:	US
Telephone Number	:	904-288-8910
Fax Number	:	904-288-8912

Provider Business Practice Location Address
First Line	:	3663 CROWN POINT CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5967
Country	:	US
Telephone Number	:	904-288-8910
Fax Number	:	904-288-8912

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	01/24/2019

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Directions to “ LAUREN ADAMS ” Practice Location

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