Provider Demographics
NPI:1609383074
Name:SPERANZA, JENNIFER FRANCES (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FRANCES
Last Name:SPERANZA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:FRANCES
Other - Last Name:BOWIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:398 OVERBROOK DR E
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2833
Mailing Address - Country:US
Mailing Address - Phone:727-588-3335
Mailing Address - Fax:
Practice Address - Street 1:8254 118TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5027
Practice Address - Country:US
Practice Address - Phone:727-541-5304
Practice Address - Fax:727-546-8527
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-06
Last Update Date:2018-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist