MEDICARE: MRS. CHRISTINE HOLMES O.T./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
1	225X00000X	Occupational Therapist	5530	FL

General Provider Information

NPI Number	:	1982816997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE HOLMES O.T./L

Provider Business Mailing Address
First Line	:	602 N.W. 13 ST
Second Line	:	APT 33
City	:	BOCA RATON
State	:	FL
Zip	:	33486-2438
Country	:	US
Telephone Number	:	561-706-1786
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 W CYPRESS ST
Second Line	:	SUITE 401
City	:	TAMPA
State	:	FL
Zip	:	33607-4145
Country	:	US
Telephone Number	:	866-990-8880
Fax Number	:	866-990-8848

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	05/22/2014

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