Provider Demographics
NPI:1013226141
Name:MEHLER, JILLIAN (MT-BC,NMT)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:
Last Name:MEHLER
Suffix:
Gender:F
Credentials:MT-BC,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WEST AVE
Mailing Address - Street 2:# 1033
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5542
Mailing Address - Country:US
Mailing Address - Phone:305-528-5836
Mailing Address - Fax:
Practice Address - Street 1:10725 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8162
Practice Address - Country:US
Practice Address - Phone:305-274-7883
Practice Address - Fax:305-274-4271
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL08038225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist