Provider Demographics
NPI:1215322086
Name:GARCIA, JESSICA (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 ROBIN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4431
Mailing Address - Country:US
Mailing Address - Phone:239-285-5651
Mailing Address - Fax:239-315-4125
Practice Address - Street 1:501 GOODLETTE RD STE D302
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5664
Practice Address - Country:US
Practice Address - Phone:239-285-5651
Practice Address - Fax:239-285-5651
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT16963225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014636700Medicaid