MEDICARE: MRS. TRACY LEE JETTE LPTA

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	225200000X	Physical Therapy Assistant	PTA11035	FL

General Provider Information

NPI Number	:	1477801496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRACY LEE JETTE LPTA

Provider Business Mailing Address
First Line	:	5836 29TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-3322
Country	:	US
Telephone Number	:	727-687-1096
Fax Number	:

Provider Business Practice Location Address
First Line	:	5836 29TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33710-3322
Country	:	US
Telephone Number	:	727-687-1096
Fax Number	:

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

Provider Enumeration Date	:	08/23/2012
Last Update Date	:	08/23/2012

Similar Medicare Providers

1265495212 — DR. THOMAS KEVIN FLANAGAN OD
Practice Location Address:

3322 DR MARTIN LUTHER KING ST N
ST PETERSBURG, FL
33704-1212

Practice Phone: 727-895-3443
Practice Fax:

1548384522 — THOMAS K FLANAGAN OD AND ASSOCIATES PA
Practice Location Address:

3322 DR MARTIN LUTHER KING JR ST N
ST PETERSBURG, FL
33704-1212

Practice Phone: 727-895-3443
Practice Fax: 727-895-3443

1386380053 — DR. DREW MICHAEL MARCELLO DC
Practice Location Address:

3322 9TH ST N
ST PETERSBURG, FL
33704-1212

Practice Phone: 727-823-4663
Practice Fax:

1881403749 — DENASAN SPALLA DC
Practice Location Address:

3322 DR MARTIN LUTHER KING JR ST N
ST PETERSBURG, FL
33704-1212

Practice Phone: 727-823-4663
Practice Fax:

1164477162 — MEL'S HEART OF GOLD SERVICES
Practice Location Address:

421 W BRIDGE ST
SAINT MARTINVILLE, LA
70582-3322

Practice Phone: 337-315-5643
Practice Fax: 337-394-3771

1053450825 — ADAMS ACTIVELY AGING INC.
Practice Location Address:

3145 SYLVANIE ST
SAINT JOSEPH, MO
64501-3322

Practice Phone: 816-671-0032
Practice Fax:

Directions to “ MRS. TRACY LEE JETTE LPTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.