Jaclyn Michelle Brooke Roero, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT17693 Issued in FL

Practice address

1790 SW 43Rd Way
Fort Lauderdale, FL 33317-5701

Phone

(855) 442-2454

Fax

(954) 206-7699

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1104374651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 SW 43RD WAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333175701",
            "telephone_number": "855-442-2454",
            "fax_number": "954-206-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 SW 43RD WAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333175701",
            "telephone_number": "855-442-2454",
            "fax_number": "954-206-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROERO",
        "first_name": "JACLYN",
        "middle_name": "MICHELLE BROOKE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT17693",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT17693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018832000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Rodriguez
• Telma N Rodriguez
• Veronica Rodriguez
• Yanliceth Rodriguez
• Yvonne Marie Rodriguez, L.C.S.W.
• Roger H Stewart MD PA
• Roger Verno D C PA
• Asausha Rogers
• Brian Anthony Rogers, M.D.
• Jesse Rogers

• All providers in Fort Lauderdale, FL
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.

Verify at the official NPI Registry.