Individual ProviderMary Stacy LilesOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4833 Staghorn Ct, Winter Springs, FL 32708-4926(407) 760-7030PECOS EnrollmentBased on the most recent information from CMS, provider Mary Stacy Liles 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 2 days ago.Profile DetailsProvider ID1912123399Provider TypeIndividualFull NameLiles, Mary StacyTitleMrs.CredentialOTRLGenderFemaleSole ProprietorYesEnumeration Date4/17/2007Last Updated6/1/2009Contact InformationPractice LocationPractice Address4833 Staghorn Ct, Winter Springs, FL 32708-4926Phone(407) 760-7030Fax(321) 972-5028Mailing LocationMailing Address4833 Staghorn Ct, Winter Springs, FL 32708-4926PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseOT 9254Florida