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General NPI Number Information
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NPI Number | 1427747385
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Entity Type | Individual
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Provider Name | JESSICA LYNNE SOPOTNICK DC
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Gender | Female
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1301 BEVILLE RD STE 6
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1503
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Country | US
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Telephone | 386-322-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 CORACI BLVD APT 1206
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City | PORT ORANGE
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State | FL
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Zip | 32128-7567
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Country | US
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Telephone | 810-335-0085
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Fax | 810-335-0085
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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 | 14251
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License Number State | FL
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