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NPI Code Detail

MEDICARE: MELISSA GRACE OTR/L

MEDICARE: MELISSA GRACE 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
1225X00000XOccupational TherapistOT7938FL

Other Identifiers

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

General Provider Information

NPI Number : 1922175710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GRACE OTR/L
Provider Business Mailing Address
First Line : 3305 S ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-6125
Country : US
Telephone Number : 407-852-3310
Fax Number : 407-852-3301
Provider Business Practice Location Address
First Line : 12702 SCIENCE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32826-3016
Country : US
Telephone Number : 407-281-0441
Fax Number : 407-281-0422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 01/24/2011

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Directions to “ MELISSA GRACE OTR/L” Practice Location

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