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General NPI Number Information
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NPI Number | 1275702060
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Entity Type | Individual
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Provider Name | JEANETTE CASANOVA O.T.R.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 12608 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33186-1867
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Country | US
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Telephone | 305-412-4177
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Fax |
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Provider Business Mailing Address
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Address Line | 6141 SW 63RD AVE
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-2141
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Country | US
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Telephone | 305-663-8192
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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 | OT11948
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License Number State | FL
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