MEDICARE: VERONICA JENKINS M.S, RMHCI

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	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1578147070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA JENKINS M.S, RMHCI

Provider Business Mailing Address
First Line	:	13923 FELIX WILL RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-2414
Country	:	US
Telephone Number	:	813-204-0560
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 S WARE BLVD STE 805
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4456
Country	:	US
Telephone Number	:	813-204-0560
Fax Number	:

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

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	06/17/2021

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