Individual provider Active NPI

Jeniffer Gonzalez, MS, OTR/L

  • Pediatric Occupational Therapist
  • Sunrise, FL
National Provider Identifier
1669648200
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 13037 Issued in FL
Practice address
1165 NW 134TH Ave
Sunrise, FL 33323-2914
Phone
(786) 877-9293
NPI assigned
May 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT 13037 FL Primary

Addresses

Primary practice location

1165 NW 134TH Ave
Sunrise, FL 33323-2914

Mailing address

1165 NW 134TH Ave
Sunrise, FL 33323-2914
Phone (786) 877-9293

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT 13037FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeniffer Gonzalez, Ms, Otr/L, P.a. Pediatrics CurrentSince May 21, 2023 Accepting new patients
Adults to Pediatrics Therapy LLC Past Accepting new patients

Organizations & group practices 2

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": "1209859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1669648200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 NW 134TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232914",
            "telephone_number": "786-877-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 NW 134TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232914",
            "telephone_number": "786-877-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENIFFER",
        "name_prefix": "Ms.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-04",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT 13037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.