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General NPI Number Information
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NPI Number | 1164543500
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Entity Type | Individual
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Provider Name | JACQUELINE N PERRI M.S.P.T
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 3508 SEAFORD LN
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City | CASSELBERRY
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State | FL
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Zip | 32707-6013
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Country | US
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Telephone | 321-239-2814
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Fax |
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Provider Business Mailing Address
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Address Line | 3508 SEAFORD LN
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City | CASSELBERRY
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State | FL
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Zip | 32707-6013
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Country | US
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Telephone | 321-239-2814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 22403
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License Number State | FL
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