Individual
JERELYNE DE CASTRO IDICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 POINT MEADOWS DR UNIT 1102, JACKSONVILLE, FL 32256-9134
(973) 931-6186
Mailing address
147 RYAN DR, PALM COAST, FL 32164-6486
(973) 931-6186
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18327
FL
Other
Enumeration date
03/19/2020
Last updated
09/21/2020
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