Healthcare Provider Details

I. General information

NPI: 1750208526
Provider Name (Legal Business Name): MS. JARIELYS CRISTHAL OJEDA X
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29228 US 19 N
CLEARWATER FL
33761-2101
US

IV. Provider business mailing address

190 112TH AVE N APT 1402
SAINT PETERSBURG FL
33716-3271
US

V. Phone/Fax

Practice location:
  • Phone: 727-351-4191
  • Fax:
Mailing address:
  • Phone: 727-269-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberO246598294000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: