Healthcare Provider Details

I. General information

NPI: 1497061360
Provider Name (Legal Business Name): JESSICA ALAINE INSCHO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2010
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12416 66TH ST STE A
LARGO FL
33773-3430
US

IV. Provider business mailing address

255 59TH ST N
SAINT PETERSBURG FL
33710-8539
US

V. Phone/Fax

Practice location:
  • Phone: 277-547-4700
  • Fax: 727-394-8661
Mailing address:
  • Phone: 727-302-3751
  • Fax: 727-345-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 25811
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT25811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: