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1952952087
JEROME TIMOTHY FOUNTAIN
HIALEAH, FL
NPI
1952952087
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL OTA17452)
Enumeration Date
2019-09-20
Last Update Date
2019-09-20
Business Address
JEROME TIMOTHY FOUNTAIN
17670 NW 78TH AVE
HIALEAH, FL 33015-3664
Phone number: 305-512-5757
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Mailing Address
JEROME TIMOTHY FOUNTAIN
11650 NW 29TH MNR
SUNRISE, FL 33323-1649
Phone number: 239-867-1879
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