Healthcare Provider Details

I. General information

NPI: 1568799088
Provider Name (Legal Business Name): JENNIFER RENEE NITZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER ARNOLD

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2736 UNIVERSITY BLVD W STE 6
JACKSONVILLE FL
32217-2170
US

IV. Provider business mailing address

2736 UNIVERSITY BLVD W STE 6
JACKSONVILLE FL
32217-2170
US

V. Phone/Fax

Practice location:
  • Phone: 352-422-1126
  • Fax: 904-202-0112
Mailing address:
  • Phone: 352-422-1126
  • Fax: 904-202-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT13794
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: