Individual provider Active NPI

Juliette Govanlu, OTA

  • Occupational Therapy Assistant
  • Pembroke Pines, FL
National Provider Identifier
1952969297
Registry record updated Jun 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
14502 Issued in FL
Practice address
1701 NW 107TH Ave
Pembroke Pines, FL 33026-2805
Phone
(786) 587-9844
NPI assigned
Jun 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X 14502 FL Primary

Addresses

Primary practice location

1701 NW 107TH Ave
Pembroke Pines, FL 33026-2805

Mailing address

824 N Golf Dr
Hollywood, FL 33021-6144
Phone (305) 323-8864

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
14502FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559433600000",
    "number": "1952969297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 N GOLF DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216144",
            "telephone_number": "305-323-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NW 107TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262805",
            "telephone_number": "786-587-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVANLU",
        "first_name": "JULIETTE",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2019-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "14502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2019; 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.