Individual provider Active NPI

Yeniby Fernandez, OTD, OTR/L

  • Occupational Therapist
  • Lutz, FL
National Provider Identifier
1144973181
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT22711 Issued in FL
Practice address
16102 N Florida Ave
Lutz, FL 33549-6129
Phone
(813) 873-1936
Fax
(813) 873-8837
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT22711 FL Primary

Addresses

Primary practice location

16102 N Florida Ave
Lutz, FL 33549-6129

Mailing address

4703 Foxshire Cir
Tampa, FL 33624-4307
Phone (813) 399-9711

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT22711FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therakids Plus, Inc. Occupational Therapist CurrentSince Feb 6, 2022 Accepting new patients

Locations

16102 N Florida Ave
Lutz, FL 33549
Phone (813) 873-1936

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1144973181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4703 FOXSHIRE CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336244307",
            "telephone_number": "813-399-9711",
            "fax_number": "813-873-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16102 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496129",
            "telephone_number": "813-873-1936",
            "fax_number": "813-873-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "YENIBY",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT22711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.