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NPI Code Detail

MEDICARE: JESSICA L JENNEY PT, DPT

MEDICARE: JESSICA L JENNEY PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician031679-1NY
2225100000XPhysical Therapist12714NC
3225100000XPhysical Therapist26356FL

General Provider Information

NPI Number : 1932432275
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L JENNEY PT, DPT
Provider Business Mailing Address
First Line : 19030 BATES AVE
Second Line :
City : EUSTIS
State : FL
Zip : 32736-2205
Country : US
Telephone Number : 585-738-7295
Fax Number :
Provider Business Practice Location Address
First Line : 5401 W KENNEDY BLVD STE 100
Second Line :
City : TAMPA
State : FL
Zip : 33609-2457
Country : US
Telephone Number : 650-867-0522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 04/02/2021

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Directions to “ JESSICA L JENNEY PT, DPT” Practice Location

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