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Individual

JULISSA MARIA VELEZ TAVERAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1851 GOLDEN EAGLE WAY STE 43, FLEMING ISLAND, FL 32003-4334
(904) 736-3470
Mailing address
1132 MCKINLEY CT, JACKSONVILLE, FL 32205-7947

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
017376
NY
225XP0200X
Pediatric Occupational Therapist
Primary
15898
FL

Other

Enumeration date
04/24/2012
Last updated
03/25/2019
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