Provider Demographics
NPI:1487797676
Name:ALLENDER, JEAN (OTR)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:
Last Name:ALLENDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:BONNICI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:805 N LAKE CLAIRE CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8489
Mailing Address - Country:US
Mailing Address - Phone:407-977-7343
Mailing Address - Fax:
Practice Address - Street 1:3403 TECHNOLOGICAL AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1476
Practice Address - Country:US
Practice Address - Phone:407-681-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9779225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686637Medicare ID - Type Unspecified