Provider Demographics
NPI:1144413758
Name:CIFARELLI, JILLIAN (MOTR/L)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:CIFARELLI
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 SW 109TH AVE
Mailing Address - Street 2:APT 206
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5542
Mailing Address - Country:US
Mailing Address - Phone:973-943-6687
Mailing Address - Fax:
Practice Address - Street 1:447 NW 73RD AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1608
Practice Address - Country:US
Practice Address - Phone:954-583-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12721225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892152100Medicaid