Jessica Formul

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

15926 Issued in FL

Practice address

3066 S Jog Rd
Greenacres, FL 33467-2053

Phone

(561) 450-5080

NPI assigned

Feb 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1356881353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 SW 13TH ST",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456210",
            "telephone_number": "561-908-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 S JOG RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672053",
            "telephone_number": "561-450-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMUL",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "15926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ann Denise Friedman, L.C.S.W.
• Friend of a Friend, Inc. (Home Care of the Palm Beaches)

• Occupational Therapy Assistant in Greenacres, FL
• Providers in Greenacres, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.