Provider Demographics
NPI:1043066533
Name:SCIACOVELLI, JEAN
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:SCIACOVELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1292 MCNEAL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-6022
Mailing Address - Country:US
Mailing Address - Phone:352-835-2007
Mailing Address - Fax:
Practice Address - Street 1:1292 MCNEAL RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-6022
Practice Address - Country:US
Practice Address - Phone:352-835-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No253Z00000XAgenciesIn Home Supportive Care