MEDICARE: JAMES STEGEMAN

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	224Z00000X	Occupational Therapy Assistant	OTA13841	FL

General Provider Information

NPI Number	:	1982012597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES STEGEMAN

Provider Business Mailing Address
First Line	:	2515 FIRST ST
Second Line	:	APT #9
City	:	FORT MYERS
State	:	FL
Zip	:	33901-2473
Country	:	US
Telephone Number	:	239-560-0374
Fax Number	:	239-491-3057

Provider Business Practice Location Address
First Line	:	904 LEE BLVD
Second Line	:	UNIT 106
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-4953
Country	:	US
Telephone Number	:	239-674-9374
Fax Number	:	239-491-3057

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

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	07/28/2014

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Directions to “ JAMES STEGEMAN ” Practice Location

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