Healthcare Provider Details

I. General information

NPI: 1437576238
Provider Name (Legal Business Name): JAD ESMOND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 04/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 SIMS CREEK LN
JUPITER FL
33458-7984
US

IV. Provider business mailing address

6671 W INDIANTOWN RD SUITE 129
JUPITER FL
33458-3991
US

V. Phone/Fax

Practice location:
  • Phone: 561-718-9844
  • Fax: 561-744-8870
Mailing address:
  • Phone: 561-718-9844
  • Fax: 561-744-8870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberOT11518
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT11518
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOT11518
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT11518
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT11518
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT11518
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT11518
License Number StateTN
# 8
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT11518
License Number StateTN
# 9
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT11518
License Number StateTN

VIII. Authorized Official

Name: MRS. ANITA MARIE MAREUS
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: OTR
Phone: 954-865-3705