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NPI Code Detail

MEDICARE: DR. JESSICA SOPHIA JANNECK-KOWALEWSKI MD

MEDICARE: DR. JESSICA SOPHIA JANNECK-KOWALEWSKI MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1639016538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA SOPHIA JANNECK-KOWALEWSKI MD
Provider Business Mailing Address
First Line : 8827 GRISTMILL WAY
Second Line :
City : MILTON
State : FL
Zip : 32583-7550
Country : US
Telephone Number : 201-988-0371
Fax Number : 201-988-0371
Provider Business Practice Location Address
First Line : 7800 US HIGHWAY 98 W
Second Line :
City : MIRAMAR BEACH
State : FL
Zip : 32550-7228
Country : US
Telephone Number : 850-737-8750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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