Healthcare Provider Details

I. General information

NPI: 1588008395
Provider Name (Legal Business Name): JENNIFER ZIRBEL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 ASHLEY LAKES DR
ODESSA FL
33556-1742
US

IV. Provider business mailing address

2150 ASHLEY LAKES DR
ODESSA FL
33556-1742
US

V. Phone/Fax

Practice location:
  • Phone: 813-892-1413
  • Fax:
Mailing address:
  • Phone: 813-892-1413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT7349
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: