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General NPI Number Information
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NPI Number | 1265762959
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Entity Type | Individual
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Provider Name | JENNIFER AVIDAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/03/2010
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Last Update Date | 01/03/2010
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Provider Practice Location Address
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Address Line | 2642 COLLINS AVE SUITE 201
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4738
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Country | US
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Telephone | 305-890-4622
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 NE 190TH ST APT #1119
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City | AVENTURA
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State | FL
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Zip | 33180-2753
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Country | US
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Telephone | 305-692-7669
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 13021
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License Number State | FL
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