Provider Demographics
NPI:1073076618
Name:DUARTE, JENILEE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JENILEE
Middle Name:MARIE
Last Name:DUARTE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NE 29TH ST APT 905
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5236
Mailing Address - Country:US
Mailing Address - Phone:786-202-8366
Mailing Address - Fax:
Practice Address - Street 1:1501 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6623
Practice Address - Country:US
Practice Address - Phone:305-599-3021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19994225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist