Provider Demographics
NPI:1790574960
Name:ADLAM, JAZMIN I
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:I
Last Name:ADLAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7075 KINGSPOINTE PKWY STE 14
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-6542
Mailing Address - Country:US
Mailing Address - Phone:321-732-3723
Mailing Address - Fax:
Practice Address - Street 1:7075 KINGSPOINTE PKWY STE 14
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-6542
Practice Address - Country:US
Practice Address - Phone:321-732-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT26087225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist