Healthcare Provider Details

I. General information

NPI: 1972895787
Provider Name (Legal Business Name): JHANY E MEJIA MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 NW 38TH ST APT K
VIRGINIA GARDENS FL
33166-5700
US

IV. Provider business mailing address

PO BOX 661184
MIAMI SPRINGS FL
33266-1184
US

V. Phone/Fax

Practice location:
  • Phone: 786-537-8971
  • Fax:
Mailing address:
  • Phone: 786-537-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 13827
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: