Individual provider Active NPI

Jaime Hernandez Miranda, OTR

  • Occupational Therapist
  • Lake Worth, FL
National Provider Identifier
1336206481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT5571 Issued in FL
Practice address
6181 Serene Run
Lake Worth, FL 33467-6559
Phone
(561) 635-9611
Fax
(561) 433-1657
NPI assigned
Jan 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 OT5571 FL Primary

Addresses

Primary practice location

6181 Serene Run
Lake Worth, FL 33467-6559

Mailing address

6181 Serene Run
Lake Worth, FL 33467-6559
Phone (561) 635-9611

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

LicenseStateTypeSpecialty
OT5571FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One to One Physical Therapy, Inc. PastSince Jul 8, 2019 Accepting new patients
A Place for You Adult Day Care and Rehab Center Corp. PastSince Jul 2, 2024 Accepting new patients
United Outreach Inc Occupational Therapist Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336206481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6181 SERENE RUN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676559",
            "telephone_number": "561-635-9611",
            "fax_number": "561-433-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6181 SERENE RUN",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676559",
            "telephone_number": "561-635-9611",
            "fax_number": "561-433-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JAIME",
        "middle_name": "HERNANDEZ",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT5571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.