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Individual

JESUS TAMAYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
12276 SAN JOSE BLVD STE 508, JACKSONVILLE, FL 32223-8618
(904) 886-3228
(904) 485-8876
Mailing address
5600 SPRING PARK RD STE 102, JACKSONVILLE, FL 32216-5989
(904) 694-2800

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18472
FL

Other

Enumeration date
08/12/2021
Last updated
08/04/2023
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