=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013432855
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAZMIN ANISSA PERRY PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2017
-----------------------------------------------------
Last Update Date | 05/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4809 N ARMENIA AVE STE 200
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33603-1436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-877-1930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4400 W SPRUCE ST APT 307
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33607-4209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-537-7350
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT32773
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------