Healthcare Provider Details

I. General information

NPI: 1649169087
Provider Name (Legal Business Name): JENNIFER DENSMORE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 UNIVERSITY PKWY STE 105
SARASOTA FL
34243-2401
US

IV. Provider business mailing address

2970 UNIVERSITY PKWY STE 105
SARASOTA FL
34243-2401
US

V. Phone/Fax

Practice location:
  • Phone: 941-360-1988
  • Fax: 941-360-1998
Mailing address:
  • Phone: 941-360-1988
  • Fax: 941-360-1998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: