Provider Demographics
NPI:1902692650
Name:JIMENEZ, DANIELLA CAROLINA (OTR/L)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:CAROLINA
Last Name:JIMENEZ
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6341 CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-9822
Mailing Address - Country:US
Mailing Address - Phone:305-878-0321
Mailing Address - Fax:
Practice Address - Street 1:814 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4564
Practice Address - Country:US
Practice Address - Phone:407-931-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT26031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist