Provider Demographics
NPI:1467425801
Name:RESTREPO, JENNIFER LYNN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:RESTREPO
Suffix:
Gender:F
Credentials:ATC
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11200 SW 8 STREET
Mailing Address - Street 2:FLORIDA INTERNATIONAL UNIVERSITY, ZEB 251B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199-0001
Mailing Address - Country:US
Mailing Address - Phone:305-348-3398
Mailing Address - Fax:305-348-3571
Practice Address - Street 1:11200 SW 8 STREET
Practice Address - Street 2:FLORIDA INTERNATIONAL UNIVERSITY, ZEB 251B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-0001
Practice Address - Country:US
Practice Address - Phone:305-348-3398
Practice Address - Fax:305-348-3571
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 13362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer