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General NPI Number Information
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NPI Number | 1225916893
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Entity Type | Individual
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Provider Name | JACLYN KEENEY
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Gender | Female
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 3313 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3606
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Country | US
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Telephone | 754-202-3457
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Fax |
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Provider Business Mailing Address
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Address Line | 20000 W DIXIE HWY APT 9103
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City | MIAMI
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State | FL
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Zip | 33180-1951
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 43630
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License Number State | FL
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