Provider Demographics
NPI:1336875905
Name:CARICO, BROOKE (OTR)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:CARICO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6806 POINTE OF WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3803
Mailing Address - Country:US
Mailing Address - Phone:301-873-6863
Mailing Address - Fax:
Practice Address - Street 1:3061 DONNELLY DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462-6422
Practice Address - Country:US
Practice Address - Phone:301-873-6863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT21865225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist