Provider Demographics
NPI:1558018788
Name:SHELTON, CAROLINE EMORY (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:EMORY
Last Name:SHELTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13200 MCCORMICK DR
Mailing Address - Street 2:
Mailing Address - City:WESTCHASE
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3010
Mailing Address - Country:US
Mailing Address - Phone:813-814-5971
Mailing Address - Fax:
Practice Address - Street 1:13200 MCCORMICK DR
Practice Address - Street 2:
Practice Address - City:WESTCHASE
Practice Address - State:FL
Practice Address - Zip Code:33626-3010
Practice Address - Country:US
Practice Address - Phone:813-814-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22841225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22841OtherFLORIDA DEPARTMENT OF HEALTH