Provider Demographics
NPI:1427524214
Name:JEAN-GILLES, ERNA ROSE (COTA/L)
Entity type:Individual
Prefix:
First Name:ERNA
Middle Name:ROSE
Last Name:JEAN-GILLES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2599 NW 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2443
Mailing Address - Country:US
Mailing Address - Phone:954-485-8873
Mailing Address - Fax:
Practice Address - Street 1:2599 NW 55TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-2443
Practice Address - Country:US
Practice Address - Phone:954-485-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant