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General NPI Number Information
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NPI Number | 1194149526
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Entity Type | Individual
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Provider Name | JESSICA R CACERES D.C
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Gender | Female
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 2650 BAHIA VISTA ST STE 304
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City | SARASOTA
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State | FL
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Zip | 34239-2634
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Country | US
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Telephone | 941-258-8462
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 BAHIA VISTA ST STE 304
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City | SARASOTA
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State | FL
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Zip | 34239-2634
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Country | US
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Telephone | 941-777-3375
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11103
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License Number State | FL
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