Individual provider Active NPI

Rene Jaquez, OTR/L

  • Occupational Therapist
  • Kissimmee, FL
National Provider Identifier
1770804270
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT10272 Issued in FL
Practice address
2307 Lily Pad LN
Kissimmee, FL 34743-3677
Phone
(407) 344-4143
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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 OT10272 FL Primary

Addresses

Primary practice location

2307 Lily Pad LN
Kissimmee, FL 34743-3677

Mailing address

2307 Lily Pad Lane
Kissimmee, FL 34743
Phone (407) 344-4143

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

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1770804270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 LILY PAD LANE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34743",
            "telephone_number": "407-344-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 LILY PAD LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347433677",
            "telephone_number": "407-344-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUEZ",
        "first_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.