Provider Demographics
NPI:1386869766
Name:BEYER, JEANNE MARIE (OTR)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:MARIE
Last Name:BEYER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1850 LEE RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2104
Mailing Address - Country:US
Mailing Address - Phone:407-792-9799
Mailing Address - Fax:407-264-8828
Practice Address - Street 1:331 N MAITLAND AVE STE A3
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4749
Practice Address - Country:US
Practice Address - Phone:407-499-2236
Practice Address - Fax:407-264-8828
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11863225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890414601Medicaid
FL890414601Medicaid