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NPI Code Detail

MEDICARE: JESSICA G CUPIDO DO

MEDICARE: JESSICA G CUPIDO DO
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
1208100000XPhysical Medicine & Rehabilitation PhysicianOS138898FL
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianOS13898FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407122468
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA G CUPIDO DO
Provider Business Mailing Address
First Line : 38135 MARKET SQ
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33542-7505
Country : US
Telephone Number : 813-284-2212
Fax Number :
Provider Business Practice Location Address
First Line : 2020 TOWN CENTER BLVD STE D
Second Line :
City : BRANDON
State : FL
Zip : 33511-2906
Country : US
Telephone Number : 813-284-2212
Fax Number : 813-377-1713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2012
Last Update Date : 03/29/2018

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Directions to “ JESSICA G CUPIDO DO” Practice Location

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