MEDICARE: JESSICA JORGENSEN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PT 26769	FL

General Provider Information

NPI Number	:	1013338029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA JORGENSEN PT, DPT

Provider Business Mailing Address
First Line	:	3401 PGA BLVD STE 500
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2825
Country	:	US
Telephone Number	:	561-352-0278
Fax Number	:

Provider Business Practice Location Address
First Line	:	4215 BURNS RD STE 280
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4625
Country	:	US
Telephone Number	:	615-727-1175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	04/27/2020

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