Individual ProviderShannon FogartyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3050 Brown Ave, Mount Dora, FL 32757-3453(352) 383-4161PECOS EnrollmentBased on the most recent information from CMS, provider Shannon Fogarty does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1518261924Provider TypeIndividualFull NameFogarty, ShannonCredentialOTGenderFemaleSole ProprietorYesEnumeration Date12/28/2010Last Updated12/28/2010Contact InformationPractice LocationPractice Address3050 Brown Ave, Mount Dora, FL 32757-3453Phone(352) 383-4161FaxUnlisted FaxMailing LocationMailing Address355 Lakepointe Dr, 201, Altamonte Springs, FL 32701-5897PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense14130Florida