Provider Demographics
NPI:1437576238
Name:JAD ESMOND, LLC
Entity type:Organization
Organization Name:JAD ESMOND, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAREUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:954-865-3705
Mailing Address - Street 1:6671 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 129
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3991
Mailing Address - Country:US
Mailing Address - Phone:561-718-9844
Mailing Address - Fax:561-744-8870
Practice Address - Street 1:168 SIMS CREEK LN
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7984
Practice Address - Country:US
Practice Address - Phone:561-718-9844
Practice Address - Fax:561-744-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT11518225X00000X, 225XE1200X, 225XF0002X, 225XG0600X, 225XH1200X, 225XL0004X, 225XM0800X, 225XP0200X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomicsGroup - Multi-Specialty
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Multi-Specialty
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow VisionGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL225X00000XOtherTAXONOMY CODE
FL1891891297OtherNPI #
FL891985200Medicaid
FL010042600Medicaid
FLOT11518OtherOT LICENSE #