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General NPI Number Information
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NPI Number | 1568319812
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Entity Type | Individual
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Provider Name | MISS JESSICA PAULA
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 5285 SUMMERLIN RD STE 101A
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City | FORT MYERS
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State | FL
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Zip | 33919-7601
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Country | US
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Telephone | 305-609-1476
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 VACARO ST # 55
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City | LABELLE
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State | FL
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Zip | 33935-5522
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Country | US
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Telephone | 305-609-0545
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 92216
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License Number State | FL
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