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General NPI Number Information
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NPI Number | 1700315736
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Entity Type | Individual
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Provider Name | JENNIFER PAUL DPT
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Gender | Female
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Dates
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Enumeration Date | 06/04/2017
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 1135 E STATE ROAD 434 STE 2001B
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-2744
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Country | US
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Telephone | 407-542-1224
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Fax | 407-542-1155
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Provider Business Mailing Address
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Address Line | 1245 NORTHERN WAY
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4352
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTT32539
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT32539
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License Number State | FL
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