Healthcare Provider Details

I. General information

NPI: 1942166210
Provider Name (Legal Business Name): JOSETTE VERES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSETTE SURPRENANT

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8839 BRYAN DAIRY RD STE 240
LARGO FL
33777-1208
US

IV. Provider business mailing address

5448 22ND ST S APT 1404
SAINT PETERSBURG FL
33712-4836
US

V. Phone/Fax

Practice location:
  • Phone: 727-461-6026
  • Fax:
Mailing address:
  • Phone: 727-331-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA28493
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: