Provider Demographics
NPI:1497915763
Name:JADICK, PATRICIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:JADICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 FARNSWORTH LN
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5022
Mailing Address - Country:US
Mailing Address - Phone:727-376-3521
Mailing Address - Fax:
Practice Address - Street 1:5028 FARNSWORTH LN
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-5022
Practice Address - Country:US
Practice Address - Phone:727-376-3521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2072225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist