MRS. SUSAN J JACKSLAND OTR
NPI 1790803229
Specialist in Melbourne, FL
- Individual
- Female
- Specialist
About SUSAN JACKSLAND
This page provides the complete NPI Profile along with additional information for Susan Jacksland, a provider established in Melbourne, Florida with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1790803229 assigned on March 2007. The practitioner's primary taxonomy code is 174400000X with license number OT4353 (FL). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1790803229 Verify this NPI
- Provider Name
- MRS. SUSAN J JACKSLAND OTR
- Other Name
- SUSAN J ADAMS OTR
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1990 NEW HAVEN AVENUE SUITE 105 MELBOURNE, FL 32904
- Location Phone
- (321) 773-1737
- Location Fax
- (321) 773-1737
- Mailing Address
- 3417 SLATE STREET WEST MELBOURNE, FL 32904
- Mailing Phone
- (407) 242-7070
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-26-2007
- Last Update Date
- 11-10-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- OT4353
- License State
- FL
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist | OT0004353 (FL) |
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790803229, enumerated as an "individual" on March 26, 2007.
The provider is located at 1990 NEW HAVEN AVENUE SUITE 105 MELBOURNE, FL 32904 and the phone number is (321) 773-1737.
Specialist with taxonomy code 174400000X.
