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NPI Code Detail

MEDICARE: MRS. JENNIFER PADILLA TIBON OTR

MEDICARE: MRS. JENNIFER PADILLA TIBON OTR
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
1225X00000XOccupational Therapist5688FL

General Provider Information

NPI Number : 1245501147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER PADILLA TIBON OTR
Provider Business Mailing Address
First Line : 9573 BENNINGTON CHASE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32829-8212
Country : US
Telephone Number : 407-737-3036
Fax Number :
Provider Business Practice Location Address
First Line : 7950 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-8229
Country : US
Telephone Number : 407-658-2046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/24/2012

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