Healthcare Provider Details

I. General information

NPI: 1013338029
Provider Name (Legal Business Name): JESSICA JORGENSEN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 BURNS RD STE 100
PALM BEACH GARDENS FL
33410-4627
US

IV. Provider business mailing address

4215 BURNS RD STE 200
PALM BEACH GARDENS FL
33410-4625
US

V. Phone/Fax

Practice location:
  • Phone: 561-694-7776
  • Fax: 561-694-3099
Mailing address:
  • Phone: 561-694-7776
  • Fax: 561-694-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26769
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 26769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: