Active NPI
Jennifer Allison Davis Polanco, OTR/L
- Occupational Therapist
- Homestead, FL
National Provider Identifier
1093157695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT13843
- Practice address
- 1087 NE 39TH Ave
Homestead, FL 33033-5926 - Phone
- (305) 799-7452
- NPI assigned
- Jul 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT13843 | FL | Primary |
Addresses
Primary practice location
1087 NE 39TH Ave
Homestead, FL 33033-5926
Mailing address
50 NW 15TH St
Ste 106
Homestead, FL 33030-4267
Phone (305) 799-7452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT13843 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1093157695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 NW 15TH ST",
"address_2": "STE 106",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330304267",
"telephone_number": "305-799-7452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1087 NE 39TH AVE",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330335926",
"telephone_number": "305-799-7452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS POLANCO",
"first_name": "JENNIFER",
"middle_name": "ALLISON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT13843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.