Basic Information
| Provider Information | |||||||||
| NPI: | 1144413758 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIFARELLI | ||||||||
| FirstName: | JILLIAN | ||||||||
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| Credential: | MOTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1530 SW 109TH AVE | ||||||||
| Address2: | APT 206 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330255542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739436687 | ||||||||
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| Practice Location | |||||||||
| Address1: | 447 NW 73RD AVE | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333171608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545837383 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2007 | ||||||||
| LastUpdateDate: | 09/26/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | OT12721 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 892152100 | 05 | FL | MEDICAID |