MEDICARE: GERALDJINN PAUL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA19410	FL

General Provider Information

NPI Number	:	1104776681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALDJINN PAUL

Provider Business Mailing Address
First Line	:	14288 TORNELIA LN
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-8634
Country	:	US
Telephone Number	:	561-921-7583
Fax Number	:

Provider Business Practice Location Address
First Line	:	14288 TORNELIA LN
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-8634
Country	:	US
Telephone Number	:	561-921-7583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ GERALDJINN PAUL ” Practice Location

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